Organization
LAND PARK PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY THOMAS RPH (PHRM MGN)
(916) 452-2616
Entity
Organization
Contact information
Practice address
4404 DEL RIO RD, SACRAMENTO, CA 95822-1126
(916) 452-2616
(916) 452-3474
Mailing address
4404 DEL RIO RD, SACRAMENTO, CA 95822-1126
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY37170
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0542452
OTHER ID NUMBER
—
05
—
PHA371700
—
CA
Enumeration date
12/13/2006
Last updated
06/19/2008
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