Provider Demographics
NPI:1073220752
Name:ST MARY S PHARMACY INC
Entity type:Organization
Organization Name:ST MARY S PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:SCHROER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-223-9090
Mailing Address - Street 1:3150 E SHIELDS AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6901
Mailing Address - Country:US
Mailing Address - Phone:559-223-9090
Mailing Address - Fax:559-223-9091
Practice Address - Street 1:3150 E SHIELDS AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6901
Practice Address - Country:US
Practice Address - Phone:559-223-9090
Practice Address - Fax:559-223-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy