DELTA DRUG COMPANY INC (NPI# 1649312174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649312174 |
| Entity Type | Organization |
| Organization Name | DELTA DRUG COMPANY INC |
| Other Organization Name | DELTA PHARMACY |
| Practice Address |
407 Main St Rio Vista CA 94571-1616 |
| Practice Telephone | 7073745135 |
| Practice Fax Number | 7073745408 |
| Mailing Telephone | 7073745135 |
| Mailing Fax Number | 7073745408 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2010-11-17 |
| Authorized Official Name | DR. KENNETH ALAN WUDEL (MANAGER) |
| Authorized Official Telephone | 7073745135 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | PHY22317 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHA223170 | 05 | |
| CA | PHARMACY LICENSE | PHY22317 | 01 |
| DEA | AL8572667 | 01 |
| Other Name | Type Code |
|---|---|
| Delta Pharmacy | Doing Business As Name - Organization |
| Street Address |
407 MAIN ST |
| City | RIO VISTA |
| State | CA |
| Zip Code | 94571-1616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598277923 | Cynthia Ann Keith | Pharmacist | 407 Main St, Rio Vista, CA 94571 | 2017-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871060087 | Kenneth Alan Wudel | Pharmacist | 407 Main St. Delta Pharmacy, Rio Vista, CA 94571 | 2018-10-25 |
| 1366960882 | Amber Huizenga | Student in an Organized Health Care Education/Training Program | 628 Montezuma Street, Rio Vista, CA 94571 | 2017-09-05 |
| 1598195315 | Paul Willem Bolle | Marriage & Family Therapist | 125 Sacramento Street, Rio Vista, CA 94571 | 2013-11-14 |
| 1023294410 | Gwen Cotter | Counselor | 393 Del Monte Drive, Rio Vista, CA 94571 | 2008-01-15 |
| 1891758629 | Raymond Wayne Donovan Jr. | Family Medicine | 417 Eagle Crest Way, Rio Vista, CA 94571 | 2006-04-11 |
| 1740898808 | Maribel Torres | Pharmacist | 310 Chardonnay Way, Rio Vista, CA 94571-1108 | 2020-07-15 |
| 1730390105 | Healthy Partnerships | Community/Behavioral Health | 1105 Airport Rd Ste A, Rio Vista, CA 94571-1267 | 2007-05-25 |
| 1033636287 | Briana Soladay | Psychologist | 501 Elm Way, Rio Vista, CA 94571-1303 | 2017-08-28 |
| 1063637262 | Thomas Eugene Gong | Dentist | 533 Main St, Rio Vista, CA 94571-1618 | 2007-04-16 |
| 1568469922 | Darrel James Brown | Nurse Practitioner | 500 Main St, Rio Vista, CA 94571-1619 | 2005-06-30 |
| Find all providers in zip 94571 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.