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General NPI Number Information
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NPI Number | 1053622860
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Entity Type | Organization
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Legal Business Name | SILVERADO PHARMACY INC
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 980 TRANCAS ST
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City | NAPA
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State | CA
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Zip | 94558-2933
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Country | US
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Telephone | 707-224-2000
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Fax | 707-224-2020
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Provider Business Mailing Address
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Address Line | 980 TRANCAS ST
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City | NAPA
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State | CA
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Zip | 94558-2933
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Country | US
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Telephone | 707-224-2000
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Fax | 707-224-2020
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY HANSEN
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Credential |
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Telephone | 707-224-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50326
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License Number State | CA
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