=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083634885
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAKERSFIELD DRUG COMPANY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 260 BERNARD ST
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93305-3541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-325-8672
-----------------------------------------------------
Fax | 661-323-1813
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260 BERNARD ST
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93305-3541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-325-8672
-----------------------------------------------------
Fax | 661-323-1813
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHARMACIST
-----------------------------------------------------
Name | MR. GARRY L WEYAND
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 661-325-8672
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 21781
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------