# PROFESSIONAL VILLAGE PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639262256
- **Authorized official:** DR. JOHN CLARKE RICHARDS IV PHARM.D. (SECRETARY/CFO)
- **Authorized official phone:** (916) 483-3455

## Contact information

- **Practice address:** 1701 PROFESSIONAL DR, SACRAMENTO, CA 95825-2104
- **Practice address phone:** (916) 483-3455
- **Practice address fax:** (916) 483-6745
- **Mailing address:** 1701 PROFESSIONAL DR, SACRAMENTO, CA 95825-2104
- **Mailing address phone:** (916) 483-3455
- **Mailing address fax:** (916) 483-6745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 08/22/2020