Organization
DOS PALOS DRUG INC
Active
Other names
PIONEER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE BARSAMIAN (MANAGER)
(209) 392-1028
Entity
Organization
Contact information
Practice address
1428 CENTER AVE, DOS PALOS, CA 93620-2320
(209) 392-1028
(209) 392-6140
Mailing address
1428 CENTER AVE, DOS PALOS, CA 93620-2320
(209) 392-1028
(209) 392-6140
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY45638
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942312939
—
CA
01
—
2115660
PK
—
Enumeration date
08/31/2006
Last updated
04/25/2017
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