Healthcare Provider Details

I. General information

NPI: 1740589241
Provider Name (Legal Business Name): H & H DRUG SORES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4674 E WATERLOO RD
STOCKTON CA
95215-2309
US

IV. Provider business mailing address

4674 E WATERLOO RD
STOCKTON CA
95215-2309
US

V. Phone/Fax

Practice location:
  • Phone: 209-931-5200
  • Fax: 209-931-5400
Mailing address:
  • Phone: 209-931-5200
  • Fax: 209-931-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. HAIG JACK YOUREDJIAN
Title or Position: PRESIDENT
Credential:
Phone: 818-956-6691