Organization
ALISAL DRUG STORES INC
Active
Other names
Pleasanton Custom Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA WOEGER (VP)
(925) 864-4455
Entity
Organization
Contact information
Practice address
4271 1ST ST, PLEASANTON, CA 94566-7123
(925) 846-4455
(925) 846-2635
Mailing address
4271 1ST ST, PLEASANTON, CA 94566-7123
(925) 846-4455
(925) 846-2635
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY35651
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1996637
PK
—
05
—
PHA356510
—
CA
Enumeration date
08/10/2006
Last updated
06/08/2015
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