Provider Demographics
NPI:1225140213
Name:NEWMAN PIONEER DRUG INC
Entity Type:Organization
Organization Name:NEWMAN PIONEER DRUG INC
Other - Org Name:NEWMAN PIONEER DRUG INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER RPH
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOPPING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:209-862-2955
Mailing Address - Street 1:1261 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMAN
Mailing Address - State:CA
Mailing Address - Zip Code:95360-1324
Mailing Address - Country:US
Mailing Address - Phone:209-862-2955
Mailing Address - Fax:209-862-3624
Practice Address - Street 1:1261 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWMAN
Practice Address - State:CA
Practice Address - Zip Code:95360-1324
Practice Address - Country:US
Practice Address - Phone:209-862-2955
Practice Address - Fax:209-862-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY463403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA31010Medicaid
2066317OtherPK
2066317OtherPK