Organization
FOOTHILL PHARMACY INC.
Active
Other names
JERRY'S DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LEIGH RICHMOND B.S. (PRESIDENT)
(559) 564-7177
Entity
Organization
Contact information
Practice address
250 E ANTELOPE AVE, SUITE B, WOODLAKE, CA 93286-1585
(559) 564-7177
(559) 564-7104
Mailing address
250 E ANTELOPE AVE, SUITE B, WOODLAKE, CA 93286-1585
(559) 564-7177
(559) 564-7104
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563191
NCPDP NUMBER
CA
05
—
PHA464180
—
CA
Enumeration date
02/26/2007
Last updated
08/22/2020
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