<Unavail>

LBN: Wade J Dahlberg Sr
<Unavail> is an health care organization with primary practice located at 2697 Lavery Ct Ste 7 , Newbury Park CA 91320-1587. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Wade J Dahlberg Sr can be contacted via phone (805) 499-0100, or through Dahlberg, William via phone (702) 373-9215.

Contact Information

Primary practice address
2697 Lavery Ct Ste 7 Newbury Park CA 91320-1587
Phone: (805) 499-0100
Fax: (805) 499-0199
Website:
Map and Directions
Authorized official contact:
Name: Dahlberg, William
Phone: (702) 373-9215

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Institutional Pharmacy 3336I0012X
Suppliers / Long Term Care Pharmacy 3336L0003X PHY50393 California

Profile Details

NPI number 1649576364
LBN Legal business name Wade J Dahlberg Sr
DBA Doing business as <Unavail>
Authorized official Dahlberg, William
Entity Organization
Organization subpart 1 No
Enumeration date Jan 27th, 2011
Last updated Feb 7th, 2011 - about 15 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 1649576364 NPPES
Other 5640087 NCPDP PROVIDER IDENTIFICATION NUMBER

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