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RANCHO SAN MIGUEL PHARMACY #21
NPI 1073818258
Pharmacy - Community/Retail Pharmacy in Stockton, CA

Active since January 19, 2011
1409 S AIRPORT WAY, STOCKTON, CA 95206(209) 939-9790 Get Directions Write a Review

NPPES record last updated: May 13, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rancho San Miguel Pharmacy #21 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANCHO SAN MIGUEL PHARMACY #21 (NPI 1073818258) is a healthcare organization registered as a community/retail pharmacy in Stockton, California and active in the NPI registry since January 2011. The organization lists Wade L. Fullmer, Pharmacist/pic, as its authorized official.

NPPES Registry Identity

NPI1073818258
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePAQINC
Location Address1409 S AIRPORT WAYStockton, CA 95206-2319
Mailing Address1409 S Airport WayStockton, CA 95206-2319 · (209) 939-9790
Phone(209) 939-9790
Organization SubpartNo
Authorized OfficialWade L. FullmerPharmacist/pic · (209) 939-0376
Enumeration DateJanuary 19, 2011
Last NPPES UpdateMay 13, 2011
✔ NPI 1073818258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · 50420
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacistTaxonomy 183500000X · License 30915 (CA)
1409 S AIRPORT WAY, Stockton, CA 95206
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Other Names 1

Doing Business AsRancho San Miguel Pharmacy #21

Other Identifiers 1

Other50420CA · Pharmacy Board License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paqinc's NPI number?

The NPI number for Paqinc is 1073818258. It was assigned to this organization in the NPPES registry on January 19, 2011. The provider is doing business as Rancho San Miguel Pharmacy #21.

Where is Paqinc located?

Paqinc is located at 1409 S Airport Way, Stockton, CA 95206. The listed phone number is (209) 939-9790.

What is Paqinc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Paqinc was last updated on May 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.