Organization
PHARMA NOVA INC
Active
Other names
Parkside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ORTEGO (PRESIDENT/PHARMACIST IN CHARGE)
(916) 224-6027
Entity
Organization
Contact information
Practice address
4404 DEL RIO RD, SACRAMENTO, CA 95822-1126
(916) 452-2200
(916) 452-2247
Mailing address
4404 DEL RIO RD, SACRAMENTO, CA 95822-1126
(916) 452-2200
(916) 452-2247
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
49289
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5633638
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/04/2009
Last updated
01/13/2010
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