Organization
GUALALA PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JAMES CHLADEK PHARMD (PRESIDENT)
(707) 884-4107
Entity
Organization
Contact information
Practice address
39351 S HIGHWAY 1, GUALALA, CA 95445-9571
(707) 884-4107
(707) 884-9024
Mailing address
PO BOX 528, 39351 S. HWY 1, GUALALA, CA 95445-0528
(707) 884-4107
(707) 884-9024
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47064
CA
Other
Enumeration date
11/16/2006
Last updated
08/22/2020
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