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General NPI Number Information
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NPI Number | 1164565024
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Entity Type | Organization
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Legal Business Name | SAVCO GENERIC DRUGS INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 2101 FOREST AVE STE 122
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City | SAN JOSE
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State | CA
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Zip | 95128-1424
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Country | US
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Telephone | 408-298-6664
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Fax | 408-298-4150
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Provider Business Mailing Address
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Address Line | 2101 FOREST AVE STE 122
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City | SAN JOSE
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State | CA
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Zip | 95128-1424
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Country | US
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Telephone | 408-298-6664
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Fax | 408-298-4150
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Authorized Official
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Title or Position | MANAGER
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Name | JOHN M PUCCINELLI
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Credential | RPH
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Telephone | 408-298-6664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PHA325060
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License Number State | CA
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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 | PHA325060
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License Number State | CA
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