Organization
PROGRESSIVE PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS H HOWARD PHARM.D (PHARMACY MANAGER)
(209) 857-4778
Entity
Organization
Contact information
Practice address
700 17TH ST STE 101, MODESTO, CA 95354-1248
(209) 857-4778
(209) 422-6196
Mailing address
700 17TH ST, SUITE 101, MODESTO, CA 95354-1247
(209) 857-4778
(209) 422-6196
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY55632
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY55632
CALIFORNIA STATE BOARD OF PHARMACY LICENSE
CA
Enumeration date
05/11/2017
Last updated
02/28/2018
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