De Anza Pharmacy

LBN: Desert Agave Pharmacy Inc
De Anza Pharmacy is an health care organization with primary practice located at 302 #B E 3Rd St , Calexico CA 92231-2760. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Desert Agave Pharmacy Inc can be contacted via phone (760) 768-2900, or through Gelman, Gregory via phone (760) 768-2900.

Contact Information

Primary practice address
302 #B E 3Rd St Calexico CA 92231-2760
Phone: (760) 768-2900
Fax: (760) 768-2929
Website:
Map and Directions
Authorized official contact:
Name: Gelman, Gregory PHARM D
Phone: (760) 768-2900

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PHY50893 California
Suppliers / Community/Retail Pharmacy 3336C0003X PHY50893 California

Profile Details

NPI number 1407122815
LBN Legal business name Desert Agave Pharmacy Inc
DBA Doing business as De Anza Pharmacy
Authorized official Gelman, Gregory PHARM D
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2012
Last updated Mar 7th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407122815 NPPES
California Other PHY50893 CALIFORNIA STATE BOARD OF PHARMACY

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