Organization
EUREKA PHARMACY LLC
Active
Other names
CLONEYS LONG TERM CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRATAP KRISHNA ANNE (MANAGING MEMBER)
(209) 298-1715
Entity
Organization
Contact information
Practice address
525 5TH ST STE B, EUREKA, CA 95501-1032
(707) 443-8452
(707) 443-2443
Mailing address
525 5TH ST, EUREKA, CA 95501-1032
(707) 443-8452
(707) 443-3059
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164713517
—
CA
01
—
2129858
PK
—
Enumeration date
04/20/2011
Last updated
08/10/2021
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