Organization
ENDERTS DRUG STORE INC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
TOM NICHOLS RPH (OWNER PHARMACIST)
(707) 464-3532
Entity
Organization
Contact information
Practice address
783 3RD ST, CRESCENT CITY, CA 95531-4316
(707) 464-4101
(707) 464-7018
Mailing address
783 3RD ST, CRESCENT CITY, CA 95531-4316
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY35933
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0531005
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA359330
—
CA
Enumeration date
10/03/2006
Last updated
03/07/2023
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