MEDICARE: NUGGET MARKET PHARMACY

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	333600000X	Pharmacy	PHY46887	CA
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5614222	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1528136769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUGGET MARKET PHARMACY

Provider Business Mailing Address
First Line	:	2000 TOWN CENTER PLZ
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-4957
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 TOWN CENTER PLZ
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-4957
Country	:	US
Telephone Number	:	916-375-8900
Fax Number	:	916-375-8740

Authorized Official
Title or Position	:	PHRM MNG
Name	:	MARTHA PAULI
Credential	:
Telephone Number	:	916-375-8900

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	09/11/2025

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