Organization
THOMAS D REIDENBACH
Active
Other names
MYERS MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS REIDENBACH (OWNER)
(707) 468-8991
Entity
Organization
Contact information
Practice address
260 HOSPITAL DR, STE 111, UKIAH, CA 95482-4533
(707) 468-8991
(707) 468-1869
Mailing address
260 HOSPITAL DR, STE 111, UKIAH, CA 95482-4533
(707) 468-1866
(707) 468-5189
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY48536
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5627798
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/01/2007
Last updated
04/13/2011
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