Provider Demographics
NPI:1497813901
Name:COMMUNITY HEALTH ENTERPRISES
Entity Type:Organization
Organization Name:COMMUNITY HEALTH ENTERPRISES
Other - Org Name:CARE CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:YAU
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-437-7370
Mailing Address - Street 1:1570 E HERNDON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3303
Mailing Address - Country:US
Mailing Address - Phone:559-437-7370
Mailing Address - Fax:559-437-7322
Practice Address - Street 1:1570 E HERNDON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3303
Practice Address - Country:US
Practice Address - Phone:559-437-7370
Practice Address - Fax:559-437-7322
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY418803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY41880OtherCA LICENSE #
CAPHY41880OtherCA LICENSE #