Organization
JOSEPH HUANTE
Active
Other names
WATERFRONT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH HUANTE RPH (OWNER)
(209) 463-7777
Entity
Organization
Contact information
Practice address
123 S COMMERCE ST, STE A, STOCKTON, CA 95202-2837
(209) 463-7777
(209) 463-2206
Mailing address
123 S COMMERCE ST, STE A, STOCKTON, CA 95202-2837
(209) 463-7777
(209) 463-2206
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY36858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0578368
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
1730124058
NPI
CA
05
—
PHA368580
—
CA
Enumeration date
06/19/2006
Last updated
04/19/2011
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