Organization
PIONEER MARKET
Active
Other names
Pioneer Market Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DUBBERKE (OWNER)
(209) 742-5550
Entity
Organization
Contact information
Practice address
5034 COAKLEY CIRCLE, SUITE 200, MARIPOSA, CA 95338-2128
(209) 742-5550
(209) 742-5551
Mailing address
PO BOX 2128, MARIPOSA, CA 95338-2128
(209) 742-5550
(209) 742-5551
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
49022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038838
—
CA
Enumeration date
07/15/2008
Last updated
05/10/2012
Update your record
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