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Organization
VLS CLAYWORTH PHARMACY INC
Active
Organization
VLS CLAYWORTH PHARMACY INC
Active
Other names
Clayworth Healthcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHIR REDDY PHARMD (OWNER)
(510) 537-9402
Entity
Organization
Contact information
Practice address
20353 LAKE CHABOT RD, STE 101, CASTRO VALLEY, CA 94546-5392
(510) 537-9402
(510) 537-1487
Mailing address
14183 CATALINA ST, SAN LEANDRO, CA 94577-5509
(510) 352-5400
(510) 352-1372
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51452
CA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141315
PK
—
Enumeration date
08/29/2006
Last updated
12/03/2015
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