Provider Demographics
NPI:1578546008
Name:DRUG THERAPY SYSTEMS COMPANY
Entity Type:Organization
Organization Name:DRUG THERAPY SYSTEMS COMPANY
Other - Org Name:PARADISE DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:AMPARO
Authorized Official - Last Name:BALBUTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:530-877-4981
Mailing Address - Street 1:6240 CLARK RD
Mailing Address - Street 2:STE B
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4167
Mailing Address - Country:US
Mailing Address - Phone:530-877-4981
Mailing Address - Fax:530-877-1048
Practice Address - Street 1:6240 CLARK RD
Practice Address - Street 2:STE B
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4167
Practice Address - Country:US
Practice Address - Phone:530-877-4981
Practice Address - Fax:530-877-1048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRUG THERAPY SYSTEMS COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-29
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH25833183500000X
CAPHA455680332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA455680Medicaid
CA0378070003Medicare ID - Type Unspecified