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General NPI Number Information
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NPI Number | 1144365776
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Entity Type | Organization
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Legal Business Name | SANDERS DRUG CO INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 1400 W KENNETH RD
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City | GLENDALE
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State | CA
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Zip | 91201-1422
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Country | US
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Telephone | 818-242-5259
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Fax | 818-247-8593
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Provider Business Mailing Address
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Address Line | 1400 W KENNETH RD
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City | GLENDALE
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State | CA
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Zip | 91201-1422
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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 | SECRETARY TRESURER
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Name | OSCAR PALLARES
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Credential | PHARMD
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Telephone | 818-242-5259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY94460
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License Number State | CA
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