| NPI | 1609003276 |
|---|---|
| Doing Business As | PORTER RIDGE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SCOTT TYREE COO 949-215-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-22 |