Organization
COUNTRY DRUG INC
Active
Other names
COUNTRY DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL WILLIS PHRM (PRESIDENT)
(530) 938-1595
Entity
Organization
Contact information
Practice address
123 MAIN ST, WEED, CA 96094-2523
(530) 938-1595
(530) 938-1597
Mailing address
123 MAIN ST, WEED, CA 96094-2523
(530) 938-1595
(530) 938-1597
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46232
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0525711
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA462320
—
CA
Enumeration date
10/25/2006
Last updated
11/19/2009
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