East Main Medical Pharmacy

LBN: East Main Medical Pharmacy
East Main Medical Pharmacy is an health care organization with primary practice located at 2524 E Main St Ste B, Stockton CA 95205-6523. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. East Main Medical Pharmacy can be contacted via phone (209) 463-1191, or through Clay, Will via phone (209) 463-1191.

Contact Information

Primary practice address
2524 E Main St Ste B Stockton CA 95205-6523
Phone: (209) 463-1191
Fax: (209) 463-3229
Website:
Map and Directions
Authorized official contact:
Name: Clay, Will
Phone: (209) 463-1191

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PHY37064 California
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1467517888
LBN Legal business name East Main Medical Pharmacy
DBA Doing business as
Authorized official Clay, Will
Entity Organization
Organization subpart 1 No
Enumeration date Dec 26th, 2006
Last updated Aug 22nd, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467517888 NPPES
Other 0548365 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID PHA370640 OTHER ID NUMBER-COMMERCIAL NUMBER

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