Organization
CROCKER DRUG INC
Active
Other names
CROCKER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FERN CROCKER (OWNER/PRESIDENT)
(619) 670-2316
Entity
Organization
Contact information
Practice address
502 EUCLID AVE, STE 100, NATIONAL CITY, CA 91950-2994
(619) 267-8159
(619) 267-8167
Mailing address
502 EUCLID AVE, STE 100, NATIONAL CITY, CA 91950-2994
(619) 267-8159
(619) 267-8167
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
20049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0538528
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA200490
—
CA
Enumeration date
04/03/2007
Last updated
09/10/2010
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