Provider Demographics
NPI:1306985635
Name:SWEETS DRUG STORE
Entity type:Organization
Organization Name:SWEETS DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-562-5991
Mailing Address - Street 1:781 SEQUOIA AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-1447
Mailing Address - Country:US
Mailing Address - Phone:559-562-5991
Mailing Address - Fax:559-562-9852
Practice Address - Street 1:781 SEQUOIA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1447
Practice Address - Country:US
Practice Address - Phone:559-562-5991
Practice Address - Fax:559-562-9852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY168723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0526713OtherNCPDP