Healthcare Provider Details

I. General information

NPI: 1558363028
Provider Name (Legal Business Name): TOWN CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 W ACEQUIA AVE
VISALIA CA
93291-6131
US

IV. Provider business mailing address

535 W ACEQUIA AVE
VISALIA CA
93291-6131
US

V. Phone/Fax

Practice location:
  • Phone: 559-734-5893
  • Fax: 559-734-5966
Mailing address:
  • Phone: 559-734-5893
  • Fax: 559-734-5966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY44492
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License NumberPHY44492
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHY44492
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License NumberPHY44492
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHY44492
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY44492
License Number StateCA

VIII. Authorized Official

Name: DR. DENNIS GENE VERMILLION
Title or Position: PHARMACIST/OWNER
Credential: PHARM.D.
Phone: 559-734-5893