1. Home
  2. Directory
  3. California
  4. Valley Springs
  5. Pharmacy
  6. NPI Profile

COUNTRY CLUB DRUG STORE
NPI 1720244353
Pharmacy - Community/Retail Pharmacy in Valley Springs, CA

Active since August 04, 2008
1919 VISTA DEL LAGO DR, STE 6, VALLEY SPRINGS, CA 95252(209) 772-1633(209) 772-1676 Get Directions Write a Review

NPPES record last updated: June 29, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Country Club Drug Store NPPES

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

COUNTRY CLUB DRUG STORE (NPI 1720244353) is a healthcare organization registered as a community/retail pharmacy in Valley Springs, California and active in the NPI registry since August 2008. The organization lists Michael Peters, Owner, as its authorized official.

NPPES Registry Identity

NPI1720244353
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMICHAEL T PETERS
Location Address1919 VISTA DEL LAGO DR, STE 6Valley Springs, CA 95252-9294
Mailing Address7302 Larkspur LnStockton, CA 95207-1629 · (209) 473-1762 · Fax (209) 473-2013
Phone(209) 772-1633
Fax(209) 772-1676
Organization SubpartNo
Authorized OfficialMichael PetersOwner · (209) 473-1762
Enumeration DateAugust 4, 2008
Last NPPES UpdateJune 29, 2009
✔ NPI 1720244353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · PHY49019
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 ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
Also ListedPharmacy · Mail Order PharmacyTaxonomy 3336M0002X
1919 VISTA DEL LAGO DR, Valley Springs, CA 95252
Open in Google Maps ↗

Other Names 1

Doing Business AsCountry Club Drug Store

Other Identifiers 1

Other5631191Ncpdp Provider Identification Number

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAUL L SYMMONDS LCSW
Social Worker (Clinical)
1919 VISTA DEL LAGO DR
VALLEY SPRINGS, CA 95252
Calaveras County (208) 772-9538
KENNETH JANG DDS, INC.
Dentist (General Practice)
1919 VISTA DEL LAGO DR, #11
VALLEY SPRINGS, CA 95252
Calaveras County (209) 772-0375
DENISE AUDREY MORDUE-LAIN NP
Registered Nurse (Women's Health Care, Ambulatory)
1919 VISTA DEL LAGO DR
VALLEY SPRINGS, CA 95252
Calaveras County (209) 772-9538
GILBERT ANTHONY SILVA PA-C
Physician Assistant
1919 VISTA DEL LAGO DR
VALLEY SPRINGS, CA 95252
Calaveras County (209) 772-9538

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 Michael T Peters's NPI number?

The NPI number for Michael T Peters is 1720244353. It was assigned to this organization in the NPPES registry on August 4, 2008. The provider is doing business as Country Club Drug Store.

Where is Michael T Peters located?

Michael T Peters is located at 1919 Vista Del Lago Dr Ste 6, Valley Springs, CA 95252. The listed phone number is (209) 772-1633.

What is Michael T Peters'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 Michael T Peters was last updated on June 29, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.