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Organization
VILLAGE PHARMACY INC
Active
Organization
VILLAGE PHARMACY INC
Active
Other names
VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WONG (CEO AND PHARMACIST)
(559) 891-8930
Entity
Organization
Contact information
Practice address
1225 ROSE AVE, SELMA, CA 93662-3227
(559) 891-8955
Mailing address
1225 ROSE AVE, SELMA, CA 93662-3227
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY48402
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5616199
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA484020
—
CA
Enumeration date
02/23/2006
Last updated
10/07/2014
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