Organization
THOMAS D REIDENBACH
Active
Other names
Myers Apothecary Shop
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS DALE REIDENBACH (OWNER)
(707) 468-8991
Entity
Organization
Contact information
Practice address
238 HOSPITAL DR STE A, UKIAH, CA 95482-4559
(707) 468-8991
(707) 468-5272
Mailing address
238 HOSPITAL DR STE A, UKIAH, CA 95482-4559
(707) 468-8991
(707) 468-5272
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY442640
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHY442640
—
CA
Enumeration date
10/16/2006
Last updated
07/01/2010
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