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General NPI Number Information
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NPI Number | 1427688316
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Entity Type | Organization
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Legal Business Name | DELTA MEDICAL PHARMACY ANTIOCH
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 1888 A ST
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City | ANTIOCH
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State | CA
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Zip | 94509-2602
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Country | US
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Telephone | 925-695-6987
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 CARLISLE CT
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City | BRENTWOOD
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State | CA
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Zip | 94513-1761
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Country | US
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Telephone | 925-695-6987
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JATIN KIRTIKUMAR MEHTA
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Credential |
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Telephone | 925-695-6987
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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 |
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License Number State |
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Taxonomy #2
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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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