Organization
SANDERS DRUG CO INC
Active
Organization
SANDERS DRUG CO INC
Active
Other names
KENNETH ROAD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR PALLARES PHARMD (SECRETARY TRESURER)
(818) 242-5259
Entity
Organization
Contact information
Practice address
1400 W KENNETH RD, GLENDALE, CA 91201-1422
(818) 242-5259
(818) 247-8593
Mailing address
1400 W KENNETH RD, GLENDALE, CA 91201-1422
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY94460
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533198
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA94460
—
CA
Enumeration date
02/21/2007
Last updated
09/12/2007
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