NPI | 1881623999 |
---|---|
Doing Business As | MANOR DRUG STORE #4 |
Entity Type | Organization |
Authorized Contact | MARYANN NOVOTNY Owner 916-922-9392 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA pha420630) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA pha420630) |
Enumeration Date | 2006-07-01 |
Last Update Date | 2008-02-04 |