Organization
HUNNELL'S MEDICAL ARTS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS K WILCOX PHARM.D. (DIRECTOR)
(209) 369-3551
Entity
Organization
Contact information
Practice address
1121 W VINE ST, LODI, CA 95240-5137
(209) 369-3551
(209) 369-0225
Mailing address
1121 W VINE ST, LODI, CA 95240-5137
(209) 369-3551
(209) 369-0225
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY40288
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0587141
NCPDP
CA
05
—
PHA402880
—
CA
Enumeration date
10/05/2006
Last updated
06/08/2010
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