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General NPI Number Information
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NPI Number | 1659952117
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Entity Type | Organization
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Legal Business Name | MEDICATION TIME PHARMACY CONSULTING
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 2109 S CRENSHAW CT
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City | VISALIA
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State | CA
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Zip | 93277-5610
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Country | US
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Telephone | 559-429-8073
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Fax | 559-471-1022
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Provider Business Mailing Address
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Address Line | 2109 S CRENSHAW CT
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City | VISALIA
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State | CA
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Zip | 93277-5610
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Country | US
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Telephone | 559-429-8073
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Fax | 559-471-1022
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MANDY MEDINA
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Credential | PHARMD
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Telephone | 559-429-8073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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