2500 Milvia Prescription Pharmacy

LBN: 2500 Milvia Prescription Pharmacy
2500 Milvia Prescription Pharmacy is an health care organization with primary practice located at 2500 Milvia St Ste 130, Berkeley CA 94704-2636. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. 2500 Milvia Prescription Pharmacy can be contacted via phone (510) 548-0773, or through Quon, Brian via phone (510) 548-0773.

Contact Information

Primary practice address
2500 Milvia St Ste 130 Berkeley CA 94704-2636
Phone: (510) 548-0773
Fax: (510) 548-6980
Website:
Map and Directions
Authorized official contact:
Name: Quon, Brian CPHT
Phone: (510) 548-0773

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY22894 California
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1700895034
LBN Legal business name 2500 Milvia Prescription Pharmacy
DBA Doing business as
Authorized official Quon, Brian CPHT
Entity Organization
Organization subpart 1 No
Enumeration date Aug 5th, 2006
Last updated Aug 31st, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1700895034 NPPES
Other 0569775 OTHER ID NUMBER
MEDICAID PHA228940 OTHER ID NUMBER

Popular Providers