Organization
FRED P BESIO CLOVERDALE PHARMACY
Active
Other names
Cloverdale Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED PAUL BESIO RPH (OWNER/PHARMACIST)
(707) 894-4414
Entity
Organization
Contact information
Practice address
790 S CLOVERDALE BLVD, CLOVERDALE, CA 95425-4010
(707) 894-4414
(707) 894-9379
Mailing address
790 S CLOVERDALE BLVD, CLOVERDALE, CA 95425-4010
(707) 894-4414
(707) 894-9379
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY365300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505529
NABP NUMBER
CA
05
—
PHA365300
—
CA
Enumeration date
08/31/2006
Last updated
07/11/2012
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