=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770679672
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARMKEE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2006
-----------------------------------------------------
Last Update Date | 01/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5796 S ELM AVE
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93706-5813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-264-2965
-----------------------------------------------------
Fax | 559-264-3160
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 457
-----------------------------------------------------
City | CARUTHERS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93609-0457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-237-0332
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DOUGLAS WILCOX
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 559-696-6333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY13360
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------