| NPI | 1689752198 |
|---|---|
| Doing Business As | MODEL PHARMACY & MEDICAL DENTAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DEBORAH A DALTON Tech 209-522-1079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY20203) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-08-12 |