MEDICARE: JUSTINO SALVADOR RPH

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	60488	CA

General Provider Information

NPI Number	:	1952683955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINO SALVADOR RPH

Provider Business Mailing Address
First Line	:	1424 BROADWAY ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-0134
Country	:	US
Telephone Number	:	707-441-1900
Fax Number	:	707-441-0681

Provider Business Practice Location Address
First Line	:	1424 BROADWAY ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-0134
Country	:	US
Telephone Number	:	707-441-1900
Fax Number	:	707-441-0681

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

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	09/15/2011

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Directions to “ JUSTINO SALVADOR RPH” Practice Location

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