Organization
PARKWOODS DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PETERS (PHRM)
(209) 475-1008
Entity
Organization
Contact information
Practice address
104 LINCOLN CTR, STOCKTON, CA 95207
(209) 475-1008
(209) 475-1027
Mailing address
104 LINCOLN CTR, STOCKTON, CA 95207
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46901
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5614323
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA46901
—
CA
Enumeration date
01/16/2007
Last updated
07/26/2007
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