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Organization
HEALTH SERVICES AGENCY OUTPATIENT PHARMACY
Active
Organization
HEALTH SERVICES AGENCY OUTPATIENT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN LEE (HSA DIRECTOR)
(209) 558-7000
Entity
Organization
Contact information
Practice address
830 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-5697
(209) 558-5631
Mailing address
830 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-5697
(209) 558-5631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHE20138
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0513730
NABP NUMBER
CA
Enumeration date
05/17/2007
Last updated
09/04/2007
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