Organization
RAYMOND Y FAT
Active
Organization
RAYMOND Y FAT
Active
Other names
SACRAMENTO MED PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND FAT RPH (PHARM)
(916) 739-1513
Entity
Organization
Contact information
Practice address
5270 ELVAS AVE, STE D, SACRAMENTO, CA 95819-2332
(916) 739-1513
(916) 739-6674
Mailing address
5270 ELVAS AVE, STE D, SACRAMENTO, CA 95819-2332
(916) 739-1513
(916) 739-6674
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY34910
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0591859
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA34910A
—
CA
Enumeration date
12/26/2006
Last updated
04/06/2010
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