Shasta Lake Drug Store INC
NPI #1568803260 in Shasta Lake, California
Provider Information
- NPI Number
- 1568803260
- Entity Type
- Organization
- Organization Name
- Shasta Lake Drug Store INC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jul 10, 2013
- Last Updated
- Aug 1, 2013
Practice Location
- Address
- 4222 SHASTA DAM BLVD
- City
- Shasta Lake
- State
- California
- ZIP Code
- 96019-9422
- Phone
- (530) 275-2700
Authorized Official
- Name
- JODI WALSH
- Title
- OFFICER/SECRETARY
- Phone
- (530) 339-1445
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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