Provider Demographics
NPI:1841377934
Name:PHARMKEE, INC.
Entity type:Organization
Organization Name:PHARMKEE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-485-2323
Mailing Address - Street 1:2041 DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-2013
Mailing Address - Country:US
Mailing Address - Phone:559-485-2323
Mailing Address - Fax:559-485-8554
Practice Address - Street 1:2041 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2013
Practice Address - Country:US
Practice Address - Phone:559-485-2323
Practice Address - Fax:559-485-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
CAPHY18288333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA182880Medicaid
CA0510570OtherNCPDP
CAPHA182880Medicaid