Organization
OLIVEHURST DRUG STORE INC
Active
Other names
OLIVEHURST DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR CAMACHO RPH (OWNER/PIC)
(530) 743-5451
Entity
Organization
Contact information
Practice address
4897 OLIVEHURST AVE, OLIVEHURST, CA 95961-4225
(530) 743-5451
(530) 743-3713
Mailing address
4897 OLIVEHURST AVE, PO BOX 720, OLIVEHURST, CA 95961-4225
(530) 743-5431
(530) 743-3731
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY48813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066990
PK
—
Enumeration date
03/13/2007
Last updated
03/28/2017
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