Provider Demographics
NPI:1619692480
Name:PANTHERS LIMITED LIABILITY CO
Entity Type:Organization
Organization Name:PANTHERS LIMITED LIABILITY CO
Other - Org Name:BE WELL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOBANPREET SINGH
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:RANDHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-715-8168
Mailing Address - Street 1:10247 VAUGHN DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-9343
Mailing Address - Country:US
Mailing Address - Phone:209-715-8168
Mailing Address - Fax:
Practice Address - Street 1:3538 MANTHEY RD STE D
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-5304
Practice Address - Country:US
Practice Address - Phone:209-915-8973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty