Organization
MEDICAL TREE PHARMACY INC
Active
Other names
TOMS MEDICAL PHARMACY WESTSIDE
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WILLIAM MCFALL RPH (PHARMACIST)
(831) 426-4252
Entity
Organization
Contact information
Practice address
1203 MISSION ST, SANTA CRUZ, CA 95060
(831) 426-4252
(831) 471-0504
Mailing address
1203 MISSION ST, SANTA CRUZ, CA 95060
(831) 426-4252
(831) 471-0504
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY375630
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0567000
OTHER ID NUMBER
—
05
—
PHA375630
—
CA
Enumeration date
11/13/2006
Last updated
07/11/2008
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