Formella, Andrea Ellen

Formella, Andrea Ellen is an sole proprietor health care provider with primary practice located at 28652 Malabar Rd , Trabuco Canyon CA 92679-1622. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Psychiatric. Pharmacy Service Providers / Psychiatric is her primary health care specialty. Formella, Andrea Ellen can be contacted via phone (512) 796-7547.

Contact Information

Primary practice address
28652 Malabar Rd Trabuco Canyon CA 92679-1622
Phone: (512) 796-7547
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 11223-40 Wisconsin
Pharmacy Service Providers / Psychiatric 1835P1300X 11223-40 Wisconsin

Profile Details

NPI number 1730664293
LBN Legal business name Formella, Andrea Ellen
Credentials PHARMD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2018
Last updated Oct 1st, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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