Healthcare Provider Details

I. General information

NPI: 1336221118
Provider Name (Legal Business Name): NUGGET MARKET PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 BROWNS VALLEY PKWY
VACAVILLE CA
95688-3062
US

IV. Provider business mailing address

130 BROWNS VALLEY PKWY
VACAVILLE CA
95688-3062
US

V. Phone/Fax

Practice location:
  • Phone: 707-469-6700
  • Fax: 707-469-6701
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY46888
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TARA STRICKLAND
Title or Position: PHARMACY MGR
Credential: CPHT
Phone: 707-469-6700