Provider Demographics
NPI:1982788006
Name:DOSE DRUGGISTS
Entity Type:Organization
Organization Name:DOSE DRUGGISTS
Other - Org Name:WOMACKS SIERRA VISTA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOMACK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-594-5656
Mailing Address - Street 1:650 E VISALIA RD
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93223-1641
Mailing Address - Country:US
Mailing Address - Phone:559-594-5656
Mailing Address - Fax:559-594-6926
Practice Address - Street 1:650 E VISALIA RD
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:CA
Practice Address - Zip Code:93223-1641
Practice Address - Country:US
Practice Address - Phone:559-594-5656
Practice Address - Fax:559-594-6926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
CAPHY340163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0570766OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CAPHA340160Medicaid
CAPHA340160Medicaid