Healthcare Provider Details

I. General information

NPI: 1952441263
Provider Name (Legal Business Name): PARKERS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W 5TH ST
HOLTVILLE CA
92250-1214
US

IV. Provider business mailing address

102 W 5TH ST
HOLTVILLE CA
92250-1214
US

V. Phone/Fax

Practice location:
  • Phone: 760-356-2826
  • Fax: 760-356-3534
Mailing address:
  • Phone: 760-356-2826
  • Fax: 760-356-3534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number55597
License Number StateCA

VIII. Authorized Official

Name: MR. ANUJ P SHUKLA
Title or Position: CEO
Credential:
Phone: 760-356-2826