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Organization

SANSUM CLINIC

Active
Other names
PRESCRIPTION PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE DAUGHTERS PHARM D (PHARMACY DIRECTOR)
(805) 563-6162
Entity
Organization

Contact information

Practice address
215 PESETAS LN, SANTA BARBARA, CA 93110-1416
(805) 964-4831
(805) 964-1562
Mailing address
215 PESETAS LN, SANTA BARBARA, CA 93110-1416
(805) 964-4831
(805) 964-1562

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHY37310
CA
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2065991
PK
05
PHA37310
CA
Enumeration date
09/05/2006
Last updated
11/01/2016
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