Provider Demographics
NPI:1497299721
Name:SAVEMART
Entity Type:Organization
Organization Name:SAVEMART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:REIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:559-246-1097
Mailing Address - Street 1:2209 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-2730
Mailing Address - Country:US
Mailing Address - Phone:559-246-1097
Mailing Address - Fax:559-897-4905
Practice Address - Street 1:2209 HOWARD ST
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-2730
Practice Address - Country:US
Practice Address - Phone:559-246-1097
Practice Address - Fax:559-897-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA47872OtherPHARMACIST LICENSE