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General NPI Number Information
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NPI Number | 1780348003
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Entity Type | Organization
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Legal Business Name | GRIZZLY PHARMACY
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 6017 N PALM AVE
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City | FRESNO
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State | CA
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Zip | 93704-1623
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Country | US
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Telephone | 559-424-0423
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Fax | 559-424-0680
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Provider Business Mailing Address
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Address Line | 6017 N PALM AVE
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City | FRESNO
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State | CA
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Zip | 93704-1623
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/CFO/SECRETARY/DIRECTOR
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Name | DREW WARTHEN
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Credential |
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Telephone | 559-424-0423
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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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