Organization
COW CREEK ENTERPRISES INC
Active
Other names
FOOTHILL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN HARNDEN (VP/MGR TECHNICIAN)
(530) 547-4403
Entity
Organization
Contact information
Practice address
9390 DESCHUTES RD, PALO CEDRO, CA 96073-9763
(530) 547-4403
(530) 547-4845
Mailing address
9390 DESCHUTES RD, PALO CEDRO, CA 96073-9763
(530) 547-4403
(530) 547-4845
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47167
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0589448
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA471670
—
CA
Enumeration date
08/10/2006
Last updated
12/13/2012
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