Provider Demographics
NPI:1952438525
Name:FOX DRUG STORE INC
Entity type:Organization
Organization Name:FOX DRUG STORE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUNNY
Authorized Official - Middle Name:RONNIE
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-251-8601
Mailing Address - Street 1:1939 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-3510
Mailing Address - Country:US
Mailing Address - Phone:559-896-1645
Mailing Address - Fax:559-896-3266
Practice Address - Street 1:7355 N PALM AVE STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5770
Practice Address - Country:US
Practice Address - Phone:559-251-8601
Practice Address - Fax:559-251-8727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59174OtherPHARMACY LICENSE
CAPHA591740Medicaid
CAPHY43121OtherPHARMACY LICENSE
CAPHY43121OtherPHARMACY LICENSE