MEDICARE: DOS PALOS DRUG INC

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	PHY45638	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2115660	OTHER		PK

General Provider Information

NPI Number	:	1942312939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOS PALOS DRUG INC

Provider Business Mailing Address
First Line	:	1428 CENTER AVE
Second Line	:
City	:	DOS PALOS
State	:	CA
Zip	:	93620-2320
Country	:	US
Telephone Number	:	209-392-1028
Fax Number	:	209-392-6140

Provider Business Practice Location Address
First Line	:	1428 CENTER AVE
Second Line	:
City	:	DOS PALOS
State	:	CA
Zip	:	93620-2320
Country	:	US
Telephone Number	:	209-392-1028
Fax Number	:	209-392-6140

Authorized Official
Title or Position	:	MANAGER
Name	:	GEORGE BARSAMIAN
Credential	:
Telephone Number	:	209-392-1028

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	04/25/2017

Similar Medicare Providers

1639215320 — MR. ROBERT ALLEN BERTELLI RPH
Practice Location Address:

1428 CENTER AVE
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93620-2320

Practice Phone: 209-392-1048
Practice Fax: 209-392-6140

1699139105 — MR. GEORGE RANDALL BARSAMIAN RPH
Practice Location Address:

1428 CENTER AVE
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93620-2320

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Practice Fax:

1295737401 — DOS PALOS MEMORIAL HOSPITAL, INC
Practice Location Address:

2118 MARGUERITE ST
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93620-2339

Practice Phone: 209-392-6121
Practice Fax: 209-392-6881

1417947433 — MRS. ALICE RUTH FOSTER-SMITH FNP/PNP
Practice Location Address:

2118 MARGUERITE ST
DOS PALOS, CA
93620-2339

Practice Phone: 209-392-6121
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1770567778 — GOLDEN VALLEY HEALTH CENTER
Practice Location Address:

1405 CALIFORNIA AVE
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1528084225 — JULIE S. REYNOLDS P.T.
Practice Location Address:

2138 MARGUERITE ST
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93620-2351

Practice Phone: 209-392-8830
Practice Fax: 209-392-8830

Directions to “DOS PALOS DRUG INC ” Practice Location

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