Avita Pharmacy 1003

LBN: Pharmedquest Pharmacy Services
Avita Pharmacy 1003 is an health care organization with primary practice located at 3590 E Imperial Hwy Rm 101 , Lynwood CA 90262-2655. 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. Pharmedquest Pharmacy Services can be contacted via phone (714) 364-4008, or through Ibarra, Dalila via phone (657) 286-7957.

Contact Information

Primary practice address
3590 E Imperial Hwy Rm 101 Lynwood CA 90262-2655
Phone: (714) 364-4008
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ibarra, Dalila
Phone: (657) 286-7957

Health care specialties

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

Profile Details

NPI number 1902409550
LBN Legal business name Pharmedquest Pharmacy Services
DBA Doing business as Avita Pharmacy 1003
Authorized official Ibarra, Dalila
Entity Organization
Organization subpart 1 No
Enumeration date Nov 17th, 2020
Last updated Mar 14th, 2024 - about 9 months 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 1902409550 NPPES
California MEDICAID 1902409550

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