Organization
CERES DRUG STORE, INC.
Active
Organization
CERES DRUG STORE, INC.
Active
Other names
CERES DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK SMERNES PHARM.D. (CEO)
(209) 537-0718
Entity
Organization
Contact information
Practice address
2929 4TH ST, CERES, CA 95307-3222
(209) 537-0718
(209) 537-4252
Mailing address
2929 4TH ST, CERES, CA 95307-3222
(209) 537-0718
(209) 537-4252
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
PHY30773
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2034704
PK
—
05
—
PHA307730
—
CA
05
—
PHY30773
—
CA
05
—
PHY57145
—
CA
Enumeration date
07/30/2006
Last updated
09/18/2019
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