Provider Demographics
NPI:1578662466
Name:FOUCH & SON PHARMACY
Entity Type:Organization
Organization Name:FOUCH & SON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER RPH
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D RPH
Authorized Official - Phone:530-473-5350
Mailing Address - Street 1:692 E STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS
Mailing Address - State:CA
Mailing Address - Zip Code:95987-0039
Mailing Address - Country:US
Mailing Address - Phone:530-473-5350
Mailing Address - Fax:530-473-5613
Practice Address - Street 1:692 E STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMS
Practice Address - State:CA
Practice Address - Zip Code:95987-0039
Practice Address - Country:US
Practice Address - Phone:530-473-5350
Practice Address - Fax:530-473-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY464623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA464620Medicaid