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General NPI Number Information
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NPI Number | 1801982798
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Entity Type | Organization
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Legal Business Name | NORTHWEST MEDICAL PHARMACY
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 7355 N PALM AVE SUITE 100
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City | FRESNO
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State | CA
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Zip | 93711-5770
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Country | US
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Telephone | 559-271-6370
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Fax | 559-271-6371
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Provider Business Mailing Address
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Address Line | 7355 N PALM AVE STE 100
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City | FRESNO
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State | CA
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Zip | 93711-5770
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Country | US
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Telephone | 559-271-6370
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Fax | 559-271-6371
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DAVID A WILCOX
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Credential | R.PH
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Telephone | 559-271-6370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PHY40808
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY40808
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License Number State | CA
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