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General NPI Number Information
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NPI Number | 1891853826
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Entity Type | Organization
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Legal Business Name | RALEYS
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 4255 E MORADA LN
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City | STOCKTON
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State | CA
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Zip | 95212-1600
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Country | US
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Telephone | 209-956-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 500 WEST CAPITOL AVE.
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City | WEST SACRAMENTO
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State | CA
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Zip | 95605-2696
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Country | US
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Telephone | 916-373-6394
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Fax | 916-372-6226
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Authorized Official
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Title or Position | SECRETARY
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Name | HELEN S SINGMASTER
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Credential |
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Telephone | 916-373-6394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY53500
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License Number State | CA
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