| NPI | 1356538771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHN OBERG Assistant Secretary 949-988-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: FL PH22890) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH27820) |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2007-09-30 |
| Last Update Date | 2022-12-29 |