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General NPI Number Information
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NPI Number | 1306998653
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Entity Type | Organization
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Legal Business Name | YOUR DRUG STORE INC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 10/20/2024
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Provider Practice Location Address
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Address Line | 2303 NILES PT
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City | BAKERSFIELD
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State | CA
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Zip | 93306-4025
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Country | US
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Telephone | 661-325-2487
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Fax | 661-325-0654
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Provider Business Mailing Address
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Address Line | 2303 NILES PT
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City | BAKERSFIELD
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State | CA
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Zip | 93306-4025
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Country | US
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Telephone | 661-325-2487
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Fax | 661-325-0654
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Authorized Official
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Title or Position | PIC, CORPORATE SECRETARY
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Name | DR. ELIZABETH MARIE ALTMILLER
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Credential | PHARMD
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Telephone | 661-325-2487
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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 | PHY30792
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License Number State | CA
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