Big Bear Valley Medical Arts Pharmacy
LBN: Mark E Wandel
Big Bear Valley Medical Arts Pharmacy is an health care organization with primary practice located at 42002 Fox Farm Rd Suite 103, Big Bear Lake CA 92315. 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 / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Mark E Wandel can be contacted via phone (909) 866-5881, or through Wandel, Mark via phone (909) 866-5881.
Contact Information
Primary practice address
42002 Fox Farm Rd Suite 103
Big Bear Lake CA 92315
Phone: (909) 866-5881
Fax: (909) 866-8510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY44374 | California |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1487737532 |
|---|---|
| LBN Legal business name | Mark E Wandel |
| DBA Doing business as | Big Bear Valley Medical Arts Pharmacy |
| Authorized official | Wandel, Mark |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Sep 21st, 2009 - about 15 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 | 1487737532 | NPPES |
| California | MEDICAID | PHA443740 | |
| California | Other | 0557073 |
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