Montclair Pharmacy
LBN: Sullivan Pharmaceuticals Inc
Montclair Pharmacy is an health care organization with primary practice located at 6123 La Salle Ave , Oakland CA 94611-2801. 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.
Sullivan Pharmaceuticals Inc can be contacted via phone (510) 339-9393, or through Sullivan, William via phone (510) 339-9393.
Contact Information
Primary practice address
6123 La Salle Ave
Oakland CA 94611-2801
Phone: (510) 339-9393
Fax: (510) 339-9394
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY38259 | California |
Profile Details
| NPI number | 1639217623 |
|---|---|
| LBN Legal business name | Sullivan Pharmaceuticals Inc |
| DBA Doing business as | Montclair Pharmacy |
| Authorized official | Sullivan, William |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 2nd, 2007 |
| Last updated | Nov 18th, 2011 - about 13 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 | 1639217623 | NPPES |
| Other | 0539431 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | PHA382590 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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