Stephen G Fisk
Organization Active NPI Community/Retail Pharmacy · Weaverville, CA
NPI 1609943281 · NPPES record last updated Oct 21, 2009
Key facts
- NPI
- 1609943281
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHY45193 (CA)
- Legal business name
- STEPHEN G FISK
- Practice address
- 1131 Main St
Ste 100
Weaverville, CA 96093-0460 - Phone
- (530) 623-3250
- Fax
- (530) 623-9419
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Stephen Fisk, RPH
- Title
- Owner
- Phone
- (530) 623-3250
Practitioners 1
-
Stephanie Fisk Kormeier, PHARM.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY45193 | CA | Yes |
Addresses
Primary practice location
1131 Main St
Ste 100
Weaverville, CA 96093-0460
Mailing address
PO Box 460
Weaverville, CA 96093-0460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0560133 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| PHA451930 | Medicaid | CA |
Other names
- TRINITY PROFESSIONAL PHARMACY
Other providers in Weaverville, CA
- Vanessa Schlegel
- Mary Ellen Simpson
- Peter Kevin Smyth
- William Patrick Sommers
- Dale R Stemple
- Colleen Lorraine Tanenbaum
- Diane M Terada
- The Wecare Group, Inc.
- The Wecare Group, Inc.
- Cristina Tissot
All providers in Weaverville, CA · Community/Retail Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.