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General NPI Number Information
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NPI Number | 1639205248
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Entity Type | Organization
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Legal Business Name | FOOTHILL PHARMACY INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 250 E ANTELOPE AVE SUITE B
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City | WOODLAKE
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State | CA
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Zip | 93286-1585
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Country | US
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Telephone | 559-564-7177
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Fax | 559-564-7104
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Provider Business Mailing Address
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Address Line | 250 E ANTELOPE AVE SUITE B
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City | WOODLAKE
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State | CA
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Zip | 93286-1585
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Country | US
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Telephone | 559-564-7177
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Fax | 559-564-7104
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN LEIGH RICHMOND
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Credential | B.S.
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Telephone | 559-564-7177
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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 | PHY46418
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License Number State | CA
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