Organization
JEFFERSON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEATLE TRAN PHARMD (CEO)
(209) 938-9556
Entity
Organization
Contact information
Practice address
1029 JEFFERSON BLVD STE A, WEST SACRAMENTO, CA 95691-3389
(916) 371-2022
(916) 371-2027
Mailing address
1029 JEFFERSON BLVD STE A, WEST SACRAMENTO, CA 95691-3389
(916) 371-2022
(916) 371-2027
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699846774
—
CA
Enumeration date
04/22/2021
Last updated
04/22/2021
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