Organization
TAKEMOTO DRUG CO
Active
Other names
MAIN DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON TAKEMOTO PHARMD (PRESIDENT)
(916) 652-7265
Entity
Organization
Contact information
Practice address
3685 TAYLOR RD, LOOMIS, CA 95650
(916) 652-7265
(916) 652-8731
Mailing address
PO BOX 552, LOOMIS, CA 95650-0552
(916) 652-7265
(916) 652-8731
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY17086
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0535003
OTHER ID NUMBER
—
05
—
PHA170860
—
CA
Enumeration date
10/25/2005
Last updated
03/25/2015
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