Healthcare Provider Details

I. General information

NPI: 1841978509
Provider Name (Legal Business Name): EUREKA PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 5TH ST
EUREKA CA
95501-1032
US

IV. Provider business mailing address

525 5TH ST STE A
EUREKA CA
95501-1032
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-8452
  • Fax: 707-443-3059
Mailing address:
  • Phone: 707-440-0460
  • Fax: 707-440-0461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. PRATAP KRISHNA ANNE
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 209-298-1715