Organization
RALEYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN S SINGMASTER (SECRETARY)
(916) 373-6394
Entity
Organization
Contact information
Practice address
3430 TULLY RD., MODESTO, CA 95350-0840
(209) 527-4600
Mailing address
500 WEST CAPITOL AVE., WEST SACRAMENTO, CA 95605-2696
(916) 373-6394
(916) 372-6226
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY53502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0552960
NCPDP
—
05
—
1952411613
—
CA
Enumeration date
08/30/2006
Last updated
06/03/2015
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