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NPI Code Detail

MEDICARE: DELTA DRUGS

MEDICARE: DELTA DRUGS
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
13336C0003XCommunity/Retail PharmacyPHY37450CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154445179
Entity Type Code : Organization
Provider Name (Legal Business Name) : DELTA DRUGS
Provider Business Mailing Address
First Line : 1666 MEDICAL CENTER DR
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92411-1257
Country : US
Telephone Number : 909-887-2596
Fax Number : 909-887-8496
Provider Business Practice Location Address
First Line : 1666 MEDICAL CENTER DR
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92411-1257
Country : US
Telephone Number : 909-887-2596
Fax Number : 909-887-8496
Authorized Official
Title or Position : PHARMACIST OWNER
Name : MR. PAUL ANTHONY TENETTE
Credential : RPN
Telephone Number : 909-887-2596
Provider Enumeration Date : 03/16/2007
Last Update Date : 06/16/2008

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Directions to “DELTA DRUGS ” Practice Location

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