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:
Map and Directions
Authorized official contact:
Name: Wandel, Mark
Phone: (909) 866-5881

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487737532 NPPES
California MEDICAID PHA443740
California Other 0557073

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