| 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 |