Organization
SUSANVILLE FAMILY PHARMACY INC
Active
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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