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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