Base Line Pharmacy

LBN: Formosa Health Corp
Base Line Pharmacy is an health care organization with primary practice located at 13451 Baseline Ave Ste C, Fontana CA 92336-5472. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Formosa Health Corp can be contacted via phone (909) 463-4631, or through Tseng, Alex via phone (909) 463-4631.

Contact Information

Primary practice address
13451 Baseline Ave Ste C Fontana CA 92336-5472
Phone: (909) 463-4631
Fax: (909) 463-0945
Website:
Map and Directions
Authorized official contact:
Name: Tseng, Alex
Phone: (909) 463-4631

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY45877 California
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1639180128
LBN Legal business name Formosa Health Corp
DBA Doing business as Base Line Pharmacy
Authorized official Tseng, Alex
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Jul 2nd, 2014 - about 10 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 1639180128 NPPES
Other 2004919 PK
MEDICAID PHA458770 PK

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