Provider Demographics
NPI:1760488050
Name:FRANK K CABLE
Entity Type:Organization
Organization Name:FRANK K CABLE
Other - Org Name:SOUTH SACRAMENTO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:CABLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:916-452-0247
Mailing Address - Street 1:5385 FRANKLIN BLVD
Mailing Address - Street 2:SUITE I
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-4717
Mailing Address - Country:US
Mailing Address - Phone:916-452-0247
Mailing Address - Fax:916-452-0214
Practice Address - Street 1:5385 FRANKLIN BLVD
Practice Address - Street 2:STE I
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-4717
Practice Address - Country:US
Practice Address - Phone:916-452-0247
Practice Address - Fax:916-452-0214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY379633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0542678OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CAPHA379630Medicaid
CA1288300001Medicare NSC