| NPI | 1306940358 |
|---|---|
| Doing Business As | ALTA VISTA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SAN LE Pharmacist In Charge 909-626-4315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY44318) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2016-12-20 |