Organization
PALO CEDRO PHARMACY
Active
Other names
PALO CEDRO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN WOFFORD PHARM D (OWNER)
(530) 547-4465
Entity
Organization
Contact information
Practice address
9180 DESCHUTES RD, PALO CEDRO, CA 96073-8716
(530) 547-4465
(530) 547-4560
Mailing address
9180 DESCHUTES RD, PALO CEDRO, CA 96073-8716
(530) 547-4465
(530) 547-4560
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47063
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0552807
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA470630
—
CA
Enumeration date
02/12/2007
Last updated
06/16/2010
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