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General NPI Number Information
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NPI Number | 1831244201
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Entity Type | Organization
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Legal Business Name | JOHN H DAYTON
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 1390 W H ST SUITE F
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City | OAKDALE
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State | CA
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Zip | 95361-3570
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Country | US
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Telephone | 209-845-9840
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Fax | 209-845-9987
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Provider Business Mailing Address
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Address Line | 1390 W H ST SUITE F
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City | OAKDALE
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State | CA
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Zip | 95361-3570
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Country | US
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Telephone | 209-845-9840
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Fax | 209-845-9987
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. JOHN H DAYTON
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Credential | RPH
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Telephone | 209-845-9840
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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 | PHY47236
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License Number State | CA
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