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General NPI Number Information
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NPI Number | 1083465199
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Entity Type | Organization
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Legal Business Name | AVENAL EXPRESS PHARMACY LLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 317 E KINGS ST
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City | AVENAL
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State | CA
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Zip | 93204-1630
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Country | US
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Telephone | 559-345-6737
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Fax | 559-386-9661
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Provider Business Mailing Address
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Address Line | PO BOX 9699
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City | BAKERSFIELD
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State | CA
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Zip | 93389-9699
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | AMANDA NESHEIWAT
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Credential |
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Telephone | 661-912-9511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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