Provider Demographics
NPI:1487688669
Name:FEDERAL DRUG EMPLOYEES CORPORATION
Entity type:Organization
Organization Name:FEDERAL DRUG EMPLOYEES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/GM
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CROCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-687-7551
Mailing Address - Street 1:FEDERAL DRUG EMPLOYEES CORPORATION
Mailing Address - Street 2:3327 STATE STREET
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105
Mailing Address - Country:US
Mailing Address - Phone:805-687-7551
Mailing Address - Fax:805-687-9870
Practice Address - Street 1:FEDERAL DRUG EMPLOYEES CORPORATION
Practice Address - Street 2:3327 STATE STREET
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105
Practice Address - Country:US
Practice Address - Phone:805-687-7551
Practice Address - Fax:805-687-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY370783336C0003X
CAPHY559183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59064OtherCA STATE RETAIL PHARM LICENSE
0547135OtherNABP
CAPHA328190Medicaid