Provider Demographics
NPI:1831836618
Name:WINTERS HEALTHCARE FOUNDATION, INC.
Entity type:Organization
Organization Name:WINTERS HEALTHCARE FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-212-1025
Mailing Address - Street 1:172 E GRANT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:CA
Mailing Address - Zip Code:95694-1780
Mailing Address - Country:US
Mailing Address - Phone:530-795-4377
Mailing Address - Fax:530-230-2776
Practice Address - Street 1:172 E GRANT AVE STE 100
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:CA
Practice Address - Zip Code:95694-1780
Practice Address - Country:US
Practice Address - Phone:530-795-4377
Practice Address - Fax:530-230-2776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINTERS HEALTHCARE FOUNDATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA58383OtherCALIFORNIA STATE BOARD OF PHARMACY