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NPI Code Detail

MEDICARE: SANDERS DRUG CO INC

MEDICARE: SANDERS DRUG CO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPHY94460CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10533198OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30533198OTHEROTHER ID NUMBER

General Provider Information

NPI Number : 1144365776
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANDERS DRUG CO INC
Provider Business Mailing Address
First Line : 1400 W KENNETH RD
Second Line :
City : GLENDALE
State : CA
Zip : 91201-1422
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W KENNETH RD
Second Line :
City : GLENDALE
State : CA
Zip : 91201-1422
Country : US
Telephone Number : 818-242-5259
Fax Number : 818-247-8593
Authorized Official
Title or Position : SECRETARY TRESURER
Name : OSCAR PALLARES
Credential : PHARMD
Telephone Number : 818-242-5259
Provider Enumeration Date : 02/21/2007
Last Update Date : 09/12/2007

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Directions to “SANDERS DRUG CO INC ” Practice Location

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