| NPI | 1629140405 |
|---|---|
| Doing Business As | FIRESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ADEYEMI OMILANA Owner 760-409-4898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY47407) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2017-01-19 |