Organization
JOHN D MANUELE & BANJAMIN C LEON
Active
Other names
SOUTH COURT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BEN LEON (OWNER)
(559) 738-8800
Entity
Organization
Contact information
Practice address
1620 S COURT ST, VISALIA, CA 93277-4962
(559) 738-8800
(559) 733-2636
Mailing address
1620 S COURT ST, VISALIA, CA 93277-4962
(559) 738-8800
(559) 733-2636
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY39863
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005149
PK
—
05
—
PMA367840
—
CA
Enumeration date
08/10/2006
Last updated
05/25/2016
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