MEDICARE: JANET A. GRASSMAN R.PH.

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
1	183500000X	Pharmacist	35335	CA

General Provider Information

NPI Number	:	1316457567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET A. GRASSMAN R.PH.

Provider Business Mailing Address
First Line	:	1000 W MOFFETT CREEK RD
Second Line	:
City	:	FORT JONES
State	:	CA
Zip	:	96032-9728
Country	:	US
Telephone Number	:	530-468-5901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1842 FORT JONES RD
Second Line	:
City	:	YREKA
State	:	CA
Zip	:	96097-9531
Country	:	US
Telephone Number	:	530-842-4182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2017
Last Update Date	:	10/14/2017

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