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General NPI Number Information
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NPI Number | 1861438962
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Entity Type | Organization
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Legal Business Name | OBRYAN COMPANY INC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 1995 ZINFANDEL DR STE 101
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-2862
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Country | US
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Telephone | 916-631-4440
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Fax | 916-635-1024
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Provider Business Mailing Address
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Address Line | 1995 ZINFANDEL DR STE 101
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-2862
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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 | PRESIDENT
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Name | AUBREY OBRYAN
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Credential |
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Telephone | 916-852-4222
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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 | PHY47520
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License Number State | CA
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