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General NPI Number Information
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NPI Number | 1700200409
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Entity Type | Organization
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Legal Business Name | CVS/CAREMARK
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Dates
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Enumeration Date | 02/15/2014
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Last Update Date | 02/15/2014
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Provider Practice Location Address
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Address Line | 14967 W WHITESBRIDGE AVE
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City | KERMAN
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State | CA
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Zip | 93630-1111
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Country | US
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Telephone | 559-842-0030
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Fax | 559-842-0036
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Provider Business Mailing Address
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Address Line | 14354 W B ST
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City | KERMAN
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State | CA
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Zip | 93630-1910
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Country | US
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Telephone | 559-289-9876
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Fax | 559-800-7451
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. JAGDIP SINGH JASPAL
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Credential | PHARM.D
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Telephone | 559-289-9876
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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 | 55129
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License Number State | CA
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