Organization
DEANNA T ON
Active
Other names
KIM LEADER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TOAN ON (PHRM D)
(916) 392-3488
Entity
Organization
Contact information
Practice address
6665 STOCKTON BLVD STE 6, SACRAMENTO, CA 95823-1634
(916) 392-3488
(916) 392-3489
Mailing address
PO BOX 245036, SACRAMENTO, CA 95824-5036
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY45648
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563913
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/29/2007
Last updated
10/05/2012
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