Organization
GREEN BROTHERS PHARMACY, INC
Active
Organization
GREEN BROTHERS PHARMACY, INC
Active
Other names
GREEN BROTHERS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ROGAN PHARM.D. (MANAGER)
(209) 948-6435
Entity
Organization
Contact information
Practice address
1617 N CALIFORNIA ST, STOCKTON, CA 95204-6117
(209) 948-6435
(209) 235-0241
Mailing address
1617 N CALIFORNIA ST, SUITE 1-F, STOCKTON, CA 95204-6117
(209) 948-6435
(209) 235-0241
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY17863
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0526915
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA178630
—
CA
Enumeration date
06/30/2006
Last updated
04/15/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up