Organization
THOMAS L PIERICK
Active
Other names
Med Shop Banning
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS L PIERICK RPH (OWNER)
(951) 849-4920
Entity
Organization
Contact information
Practice address
1035 WEST RAMSEY STREET, B-3, BANNING, CA 92220-4400
(951) 849-4920
(951) 922-2250
Mailing address
1035 WEST RAMSEY STREET, SUITE B-3, BANNING, CA 92220-4400
(951) 849-4920
(951) 922-2250
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
50230
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY50230
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-26176
NCPDP
—
01
—
5626176
NCPDP
CA
05
—
PHA-468600
—
CA
Enumeration date
03/27/2007
Last updated
09/13/2011
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