Organization
SUSANVILLE FAMILY PHARMACY INC
Active
Other names
SUSANVILLE FAMILY PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD LIM RPH (PRESIDENT)
(530) 242-6430
Entity
Organization
Contact information
Practice address
1850 SPRING RIDGE DR, STE P, SUSANVILLE, CA 96130-6100
(530) 257-8300
(530) 257-9300
Mailing address
1850 SPRING RIDGE DR, STE P, SUSANVILLE, CA 96130-6100
(530) 257-8300
(530) 257-9300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47476
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5621950
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/11/2006
Last updated
06/17/2009
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