| NPI | 1659467561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS K WILCOX Director 209-369-3551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY40288) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-06-08 |