<Unavail>
LBN: Green Brothers Pharmacy, Inc
<Unavail> is an health care organization with primary practice located at 1617 N California St , Stockton CA 95204-6117. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Green Brothers Pharmacy, Inc can be contacted via phone (209) 948-6435, or through Rogan, Edward via phone (209) 948-6435.
Contact Information
Primary practice address
1617 N California St
Stockton CA 95204-6117
Phone: (209) 948-6435
Fax: (209) 235-0241
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY17863 | California |
Profile Details
| NPI number | 1619905221 |
|---|---|
| LBN Legal business name | Green Brothers Pharmacy, Inc |
| DBA Doing business as | <Unavail> |
| Authorized official | Rogan, Edward PHARM.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Apr 15th, 2011 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619905221 | NPPES |
| Other | 0526915 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | PHA178630 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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