Organization
MERCADOS SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC FRAGOLA (OWNER)
(415) 237-3650
Entity
Organization
Contact information
Practice address
1315 OLIVER RD UNIT D, FAIRFIELD, CA 94534-3470
(707) 862-2819
Mailing address
1315 OLIVER RD UNIT D, FAIRFIELD, CA 94534-3470
(415) 237-3650
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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