Gualala Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY47064 Issued in CA

Legal business name

GUALALA PHARMACY, INC.

Practice address

39351 S Highway 1
Gualala, CA 95445-9571

Phone

(707) 884-4107

Fax

(707) 884-9024

NPI assigned

Nov 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John James Chladek, PHARMD

Title

President

Phone

(707) 884-4107

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699848663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "address_2": "39351 S. HWY 1",
            "city": "GUALALA",
            "state": "CA",
            "postal_code": "954450528",
            "telephone_number": "707-884-4107",
            "fax_number": "707-884-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39351 S HIGHWAY 1",
            "city": "GUALALA",
            "state": "CA",
            "postal_code": "954459571",
            "telephone_number": "707-884-4107",
            "fax_number": "707-884-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUALALA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHLADEK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-884-4107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen B. Cox Jr., D.D.S.
• Gena Lynn Davis, O.D.
• Lois Falk, N.P.
• Laura B Franklin, L.AC. M.S.
• Olaf Kristian Golubjatnikov
• Holly Ramona Hamm, FNP-C
• Carolyn Hand, N.P.
• Douglas Scott Herting, DOCTOR OF CHIRO
• Stephanie Hsieh
• Mark Kal, M.D.

• Community/Retail Pharmacy in Gualala, CA
• Providers in Gualala, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.