Healthcare Provider Details

I. General information

NPI: 1619273687
Provider Name (Legal Business Name): CAPITOL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 FLORIN RD # 111
SACRAMENTO CA
95823-2508
US

IV. Provider business mailing address

2923 W CAPITOL AVE
WEST SACRAMENTO CA
95691-2910
US

V. Phone/Fax

Practice location:
  • Phone: 916-231-0277
  • Fax: 916-231-0330
Mailing address:
  • Phone: 916-617-4321
  • Fax: 916-617-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY50589
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS BUI
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 916-617-4321