Organization
PAYLESS PHARMACY INC
Active
Other names
Payless Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KINGSLEY OTI (PRESIDENT)
(650) 804-0530
Entity
Organization
Contact information
Practice address
2860 DEL PASO RD STE 250, SACRAMENTO, CA 95834-9717
(916) 624-9900
Mailing address
2860 DEL PASO RD STE 250, SACRAMENTO, CA 95834-9717
(916) 624-9900
(916) 624-9901
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
51144
CA
3336L0003X
Long Term Care Pharmacy
Primary
51144
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174037626
—
CA
05
—
1669762944
—
CA
Enumeration date
11/20/2017
Last updated
05/17/2022
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