Organization
MENDOCINO PHARMACY HOLDINGS INC.
Active
Other names
Gualala Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY E BRODETSKY PHARMD (PRESIDENT, DIRECTOR)
(707) 734-0091
Entity
Organization
Contact information
Practice address
39251 SOUTH HIGHWAY 1, GUALALA, CA 95445
(707) 734-0091
(707) 962-3011
Mailing address
PO BOX 904, MENDOCINO, CA 95460-0904
(707) 734-0091
(707) 962-3011
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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