MEDICARE: PHARMKEE, 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy	PHY38015	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	0527854	OTHER	CA	NCPDP

General Provider Information

NPI Number	:	1982785010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMKEE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 782
Second Line	:	21890 COLORADO AVE, SUITE A
City	:	SAN JOAQUIN
State	:	CA
Zip	:	93660-0782
Country	:	US
Telephone Number	:	559-693-4339
Fax Number	:	559-693-1080

Provider Business Practice Location Address
First Line	:	21890 COLORADO AVENUE
Second Line	:	SUITE A
City	:	SAN JOAQUIN
State	:	CA
Zip	:	93660
Country	:	US
Telephone Number	:	559-693-4339
Fax Number	:	559-693-1080

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. DOUGLAS K WILCOX
Credential	:	PHARM.D.
Telephone Number	:	559-693-4339

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	06/08/2010

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Directions to “PHARMKEE, INC. ” Practice Location

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