Organization
FAIRCHILD MEDICAL CLINIC
Active
Parent organization
FAIRCHILD MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRCHILD MEDICAL CLINIC
Authorized official
PAULETTE ADAMS RN (CLINIC ADMINISTRATOR)
(530) 842-3507
Entity
Organization
Contact information
Practice address
475 BRUCE ST, YREKA, CA 96097-3474
(530) 842-3507
Mailing address
475 BRUCE ST, YREKA, CA 96097-3474
(530) 842-3507
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
—
—
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
1835P2201X
Ambulatory Care Pharmacist
Primary
—
—
261Q00000X
Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336330646
—
CA
Enumeration date
03/09/2021
Last updated
03/09/2021
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