Healthcare Provider Details

I. General information

NPI: 1730740242
Provider Name (Legal Business Name): DARCY COVEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DARCY COVEY RPH

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 N WILLOW AVE
CLOVIS CA
93611-4408
US

IV. Provider business mailing address

PO BOX 4278
MODESTO CA
95352-4278
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-0174
  • Fax: 559-297-0212
Mailing address:
  • Phone: 209-577-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: