Country Village Pharmacy

LBN: Country Village Pharmacy
Country Village Pharmacy is an health care organization with primary practice located at 10251 Country Club Dr Ste B, Mira Loma CA 91752-1329. 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. Country Village Pharmacy can be contacted via phone (951) 681-8889, or through Arshad, Mohammad via phone (951) 681-8889.

Contact Information

Primary practice address
10251 Country Club Dr Ste B Mira Loma CA 91752-1329
Phone: (951) 681-8889
Fax: (951) 681-2948
Website:
Map and Directions
Authorized official contact:
Name: Arshad, Mohammad PHARMACIST
Phone: (951) 681-8889

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY34166 California

Profile Details

NPI number 1659465912
LBN Legal business name Country Village Pharmacy
DBA Doing business as
Authorized official Arshad, Mohammad PHARMACIST
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Jan 23rd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659465912 NPPES
Other 1997702 PK
MEDICAID PHA341660 PK

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