Organization
BLUE DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM HEINBERG RPH (PRESIDENT)
(707) 468-4333
Entity
Organization
Contact information
Practice address
707 S DORA ST, UKIAH, CA 95482-5335
(707) 468-8707
(775) 640-8755
Mailing address
PO BOX 74, UKIAH, CA 95482-0074
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46487
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5600906
OTHER ID NUMBER
—
05
—
PHA464870
—
CA
Enumeration date
04/28/2006
Last updated
08/30/2007
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