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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700895034 | NPPES |
| Other | 0569775 | OTHER ID NUMBER | |
| MEDICAID | PHA228940 | OTHER ID NUMBER |
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