Organization
DONALD WAYNE SMITH
Active
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
Update your record
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