Organization
DONALD WAYNE SMITH
Active
Other names
Forty Nine Drug Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WAYNE SMITH RPH (OWNER)
(209) 465-2671
Entity
Organization
Contact information
Practice address
937 N YOSEMITE ST, STOCKTON, CA 95203-2216
(209) 465-2671
(209) 465-6831
Mailing address
937 N YOSEMITE ST, STOCKTON, CA 95203-2216
(209) 465-2671
(209) 465-6831
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY43499
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0579283
NAPB
CA
05
—
PHA434990
—
CA
01
—
PHY43499
STATE LICENSE #
CA
Enumeration date
06/12/2006
Last updated
07/21/2008
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