Provider Demographics
NPI:1326150319
Name:CALIFORMACY INC
Entity Type:Organization
Organization Name:CALIFORMACY INC
Other - Org Name:WESTON RANCH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDNET
Authorized Official - Prefix:
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVANEETHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-234-1020
Mailing Address - Street 1:3526 MANTHEY RD
Mailing Address - Street 2:STE H
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-5301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3526 MANTHEY RD
Practice Address - Street 2:STE H
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-5301
Practice Address - Country:US
Practice Address - Phone:209-234-1020
Practice Address - Fax:209-234-1825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY489173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0530471OtherNCPDP PROVIDER IDENTIFICATION NUMBER