Organization
RICHLAND PHARMACY
Active
Other names
RICHLAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WADE FULLMER RPH (PIC AND VP)
(209) 667-5588
Entity
Organization
Contact information
Practice address
2090 E CANAL DR, TURLOCK, CA 95380-4302
(209) 667-5588
(209) 667-4935
Mailing address
2090 E CANAL DR, TURLOCK, CA 95380-4302
(209) 667-5588
(209) 667-4935
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY30313
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0569547
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA303130
—
CA
Enumeration date
10/20/2006
Last updated
06/19/2009
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