Organization
MEDICAL DENTAL PHARMACY
Active
Other names
MEDICAL DENTAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA SMITH PHARMD (CEO)
(559) 439-1190
Entity
Organization
Contact information
Practice address
689 E NEES AVE, FRESNO, CA 93720-2106
(559) 439-1190
(559) 439-1165
Mailing address
689 E NEES AVE, FRESNO, CA 93720-2106
(559) 439-1190
(559) 439-1165
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY44342
CA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000624
PK
—
05
—
PHA44342
—
CA
Enumeration date
08/18/2006
Last updated
07/22/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us