Healthcare Provider Details

I. General information

NPI: 1093827917
Provider Name (Legal Business Name): HINAS MERCY SOUTHWEST PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9508 STOCKDALE HWY STE130
BAKERSFIELD CA
93311-3622
US

IV. Provider business mailing address

9508 STOCKDALE HWY STE130
BAKERSFIELD CA
93311-3622
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-7979
  • Fax: 661-847-0181
Mailing address:
  • Phone: 661-664-7979
  • Fax: 661-847-0181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY46640
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SANJAY PATEL
Title or Position: CFO
Credential:
Phone: 661-664-7979