| NPI | 1619905221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ROGAN Manager 209-948-6435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA PHY17863) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2011-04-15 |