Organization
DOUGLAS W. MUNDY
Active
Organization
DOUGLAS W. MUNDY
Active
Other names
Tahoe Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS W MUNDY R.PH. (OWNER/PHARMACIST)
(530) 541-0870
Entity
Organization
Contact information
Practice address
2074 LAKE TAHOE BLVD., STE. #1, SOUTH LAKE TAHOE, CA 96150
(530) 541-0870
(530) 541-0884
Mailing address
2074 LAKE TAHOE BLVD., STE. #1, SOUTH LAKE TAHOE, CA 96150
(530) 541-0870
(530) 541-0884
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY22386
CA
Other
Enumeration date
10/02/2006
Last updated
07/16/2008
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