NPI | 1699153858 |
---|---|
Doing Business As | MOLINA SOUTH SACRAMENTO MACK ROAD |
Entity Type | Organization |
Authorized Contact | KENNY HEINE VP Of Operations 858-964-1506 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA 20882) |
Enumeration Date | 2015-05-08 |
Last Update Date | 2015-05-08 |