Organization
CLINIC PHARMACIES III LLC
Active
Parent organization
CLINIC PHARMACIES III LLC
Other names
Western Sierra Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLINIC PHARMACIES III LLC
Authorized official
MICHAEL BROWN (VICE PRESIDENT, MANAGED SERVICES)
(281) 749-4764
Entity
Organization
Contact information
Practice address
844 OLD TUNNEL RD, GRASS VALLEY, CA 95945-8524
(530) 273-0182
(530) 273-0698
Mailing address
13651 DUBLIN CT, STAFFORD, TX 77477-4317
(281) 749-4000
(614) 652-0326
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
53768
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154184
PK
—
Enumeration date
06/18/2015
Last updated
09/15/2022
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