Lifetime Pharmacy Corp

LBN: Lifetime Pharmacy Corp
Lifetime Pharmacy Corp is an health care organization with primary practice located at 23080 Alessandro Blvd Ste 212, Moreno Valley CA 92553-9673. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Lifetime Pharmacy Corp can be contacted via phone (951) 656-7171, or through Vandyke, Ronald via phone (951) 656-7171.

Contact Information

Primary practice address
23080 Alessandro Blvd Ste 212 Moreno Valley CA 92553-9673
Phone: (951) 656-7171
Fax: (951) 656-6363
Website:
Map and Directions
Authorized official contact:
Name: Vandyke, Ronald
Phone: (951) 656-7171

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1558512848
LBN Legal business name Lifetime Pharmacy Corp
DBA Doing business as
Authorized official Vandyke, Ronald
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2008
Last updated Mar 10th, 2020 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1558512848 NPPES
California MEDICAID 6691210001
California Other 2117475

Popular Providers