Community Professional Pharmacy
LBN: Brian Fontaine Keys
Community Professional Pharmacy is an health care organization with primary practice located at 4510 Brockton Ave Ste 107 Ste 107, Riverside CA 92501-4020. 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.
Brian Fontaine Keys can be contacted via phone (951) 683-1200, or through Keyes, Brian via phone (951) 683-1200.
Contact Information
Primary practice address
4510 Brockton Ave Ste 107 Ste 107
Riverside CA 92501-4020
Phone: (951) 683-1200
Fax: (951) 683-8078
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY22224 | California |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1184736001 |
|---|---|
| LBN Legal business name | Brian Fontaine Keys |
| DBA Doing business as | Community Professional Pharmacy |
| Authorized official | Keyes, Brian |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 19th, 2018 - about 6 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 | 1184736001 | NPPES |
| Other | 2116108 | PK | |
| MEDICAID | PHY22224 | PK |
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