| NPI | 1376658740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY PARK VP 805-497-8258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY43809) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-08-14 |