Organization
M A C T HEALTH BOARD, INCORPORATED
Active
Organization
M A C T HEALTH BOARD, INCORPORATED
Active
Other names
MACT Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SHAWVER ALEXANDER (EXECUTIVE DIRECTOR)
(209) 754-6258
Entity
Organization
Contact information
Practice address
13975 MONO WAY STE H, SONORA, CA 95370-2824
(209) 677-5424
(888) 498-0976
Mailing address
PO BOX 939, ANGELS CAMP, CA 95222-0939
(209) 754-6245
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417527532
—
CA
Enumeration date
06/30/2021
Last updated
11/17/2022
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