Organization
COMMUNITY MEDICAL CENTERS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL H. KIRKPARICK (CEO)
(209) 373-2833
Entity
Organization
Contact information
Practice address
701 E CHANNEL ST, STOCKTON, CA 95202-2628
(209) 373-4730
(209) 944-4737
Mailing address
PO BOX 779, STOCKTON, CA 95201-0779
(209) 373-2833
(209) 373-2878
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE
46591
CA
Enumeration date
12/29/2006
Last updated
03/07/2023
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