# PAYLESS PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Payless Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174037626
- **Authorized official:** MR. KINGSLEY OTI (PRESIDENT)
- **Authorized official phone:** (650) 804-0530

## Contact information

- **Practice address:** 2860 DEL PASO RD STE 250, SACRAMENTO, CA 95834-9717
- **Practice address phone:** (916) 624-9900
- **Mailing address:** 2860 DEL PASO RD STE 250, SACRAMENTO, CA 95834-9717
- **Mailing address phone:** (916) 624-9900
- **Mailing address fax:** (916) 624-9901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 51144 | CA | — |
| 3336L0003X | Long Term Care Pharmacy | 51144 | CA | Yes |

## Other

- **Enumeration date:** 11/20/2017
- **Last updated:** 05/17/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1174037626 | — | CA |
| 05 | — | 1669762944 | — | CA |