Organization
DAMERON HOSPITAL ASSOCIATION
Active
Other names
DAMERONS LINACIA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GLASBERG B.S. PHARM (SR VP, COO)
(209) 944-5550
Entity
Organization
Contact information
Practice address
420 W ACACIA ST, STOCKTON, CA 95203-2441
(209) 466-2954
(209) 466-1558
Mailing address
420 W ACACIA ST, STOCKTON, CA 95203-2441
(209) 466-2954
(209) 466-1558
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY39485
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2077836
PK
—
05
—
PHA 394850
—
CA
Enumeration date
01/10/2007
Last updated
09/29/2015
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