Avita Pharmacy 1025

LBN: Pharmedquest Pharmacy Services
Avita Pharmacy 1025 is an health care organization with primary practice located at 3020 Saturn St Ste 100 , Brea CA 92821-6262. 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. Pharmedquest Pharmacy Services can be contacted via phone (877) 362-9778, or through Gurley, Kristen via phone (469) 592-2011.

Contact Information

Primary practice address
3020 Saturn St Ste 100 Brea CA 92821-6262
Phone: (877) 362-9778
Fax: (714) 364-1448
Website:
Map and Directions
Authorized official contact:
Name: Gurley, Kristen
Phone: (469) 592-2011

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 55894 California

Profile Details

NPI number 1568963312
LBN Legal business name Pharmedquest Pharmacy Services
DBA Doing business as Avita Pharmacy 1025
Authorized official Gurley, Kristen
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2018
Last updated Jun 14th, 2024 - about 2 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 1568963312 NPPES
California MEDICAID 1568963312
California Other 2176010

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