Organization
KIBBLE ENTERPRISES INC
Active
Organization
KIBBLE ENTERPRISES INC
Active
Other names
QUINCY DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KIBBLE PHARM D (PHARMACIST OWNER)
(530) 283-0480
Entity
Organization
Contact information
Practice address
493 MAIN ST, QUINCY, CA 95971-9120
(530) 832-4218
(530) 832-1375
Mailing address
157 COMMERCIAL ST, PORTOLA, CA 96122-9606
(530) 832-4218
(530) 283-1410
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46583
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2076757
PK
—
05
—
PHA465830
—
CA
Enumeration date
09/30/2005
Last updated
03/22/2016
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