MEDICARE: THE PILL BOX PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	39687	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2000687	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689672669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PILL BOX PHARMACY

Provider Business Mailing Address
First Line	:	1108 N LAKE ST
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93638-2112
Country	:	US
Telephone Number	:	559-674-1625
Fax Number	:	559-674-3109

Provider Business Practice Location Address
First Line	:	1108 N LAKE ST
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93638-2112
Country	:	US
Telephone Number	:	559-674-1625
Fax Number	:	559-674-3109

Authorized Official
Title or Position	:	OWNER MANAGER
Name	:	DEBRA CHU
Credential	:
Telephone Number	:	559-674-1625

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/20/2017

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Directions to “THE PILL BOX PHARMACY ” Practice Location

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