Organization
TAHOE CITY PLAZA PHARMACY
Active
Other names
tahoe city compounding pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY P SABISTINA RPH (PHARMACIST)
(530) 583-3888
Entity
Organization
Contact information
Practice address
599 NORTH LAKE BLVD, TAHOE CITY, CA 96145-7229
(530) 583-3888
(530) 583-1301
Mailing address
PO BOX 7229, TAHOE CITY, CA 96145-7229
(530) 583-3888
(530) 583-1301
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY 43340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY 43340
RETAIL PHARMACY PERMIT
CA
Enumeration date
12/01/2006
Last updated
03/07/2023
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