| Creekside Pharmacy | |
|
95 Montgomery Dr Santa Rosa CA 95404 | |
| (707) 525-1130 | |
| (707) 525-8099 |
| Full Name | Creekside Pharmacy |
|---|---|
| Speciality | Pharmacy |
| Location | 95 Montgomery Dr, Santa Rosa, California |
| Authorized Official Name and Position | Tony Ibrahim (CEO) |
| Authorized Official Contact | 7609876796 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Pharmacy 95 Montgomery Dr Suite 108 Santa Rosa CA 95404-6630 Ph: (707) 525-1130 | Creekside Pharmacy 95 Montgomery Dr Santa Rosa CA 95404 Ph: (707) 525-1130 |
| NPI Number | 1497814594 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 11/08/2024 |
| Medicare PECOS PAC ID | 2264860386 |
|---|---|
| Medicare Enrollment ID | O20200323002896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497814594 | NPI | - | NPPES |
| 2126477 | Other | PK |
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