Organization
PALCO PHARMACY A CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERILYN D ROSS RPH (PRESIDENT)
(707) 764-3591
Entity
Organization
Contact information
Practice address
113 MAIN ST, SUITE D, SCOTIA, CA 95565
(707) 764-3591
(707) 764-3797
Mailing address
PO BOX 157, SCOTIA, CA 95565-0157
(707) 764-3591
(707) 764-3797
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY43140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA348600
—
CA
Enumeration date
11/02/2005
Last updated
05/19/2020
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