Organization
RANCHO PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARD LEINOR (OWNER)
(209) 823-7658
Entity
Organization
Contact information
Practice address
1367 E YOSEMITE AVE, MANTECA, CA 95336-5003
(209) 823-7658
(209) 823-8552
Mailing address
1367 E YOSEMITE AVE, MANTECA, CA 95336-5003
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47157
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0550687
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA471570
—
CA
Enumeration date
07/30/2006
Last updated
10/04/2007
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