MEDICARE: AAMH PHARMACEUTICAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PHY53440	CA
2	3336C0003X	Community/Retail Pharmacy	PHY53440	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHY 53440	OTHER	CA	BOARD OF PHARMACY RETAIL PERMIT
2	0520735	OTHER		NCPDP

General Provider Information

NPI Number	:	1790783447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAMH PHARMACEUTICAL INC

Provider Business Mailing Address
First Line	:	110 W HARVARD BLVD
Second Line	:	#H
City	:	SANTA PAULA
State	:	CA
Zip	:	93060-3874
Country	:	US
Telephone Number	:	805-525-3313
Fax Number	:	805-933-3706

Provider Business Practice Location Address
First Line	:	110 W HARVARD BLVD
Second Line	:	#H
City	:	SANTA PAULA
State	:	CA
Zip	:	93060-3874
Country	:	US
Telephone Number	:	805-525-3313
Fax Number	:	805-933-3706

Authorized Official
Title or Position	:	PRESIDENT/PIC
Name	:	MR. MARC A AWAD
Credential	:
Telephone Number	:	805-525-3313

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/07/2015

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Directions to “AAMH PHARMACEUTICAL INC ” Practice Location

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