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General NPI Number Information
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NPI Number | 1164820197
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Entity Type | Organization
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Legal Business Name | FONSECA PHARMACY SERVICES, INC.
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 1045 G ST
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City | REEDLEY
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State | CA
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Zip | 93654-2935
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Country | US
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Telephone | 559-637-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 G ST
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City | REEDLEY
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State | CA
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Zip | 93654-2935
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Country | US
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Telephone | 559-637-7000
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/CEO
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Name | JUAN FONSECA
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Credential |
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Telephone | 559-285-6060
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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 | 51818
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License Number State | CA
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