Organization
RALEYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN S SINGMASTER (SECRETARY)
(916) 373-6394
Entity
Organization
Contact information
Practice address
1040 EMERALD BAY ROAD, SOUTH LAKE TAHOE, CA 96150-6200
(530) 541-5410
(530) 541-8264
Mailing address
500 WEST CAPITOL AVE., WEST SACRAMENTO, CA 95605-2696
(916) 373-6394
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY53481
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0562985
NCPDP
—
05
—
1215039607
—
CA
Enumeration date
09/05/2006
Last updated
05/29/2015
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