| NPI | 1154422111 |
|---|---|
| Doing Business As | BALDY VISTA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHNNY WONG President 909-762-7852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-07-17 |