Healthcare Provider Details

I. General information

NPI: 1982785671
Provider Name (Legal Business Name): EL TEJON PHARMACYCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 N CHESTER AVE
BAKERSFIELD CA
93308-1587
US

IV. Provider business mailing address

2819 N CHESTER AVE
BAKERSFIELD CA
93308-1587
US

V. Phone/Fax

Practice location:
  • Phone: 661-399-2901
  • Fax: 661-399-2908
Mailing address:
  • Phone: 661-399-2901
  • Fax: 661-399-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TINA ZOMORODIAN
Title or Position: PIC
Credential: RPH
Phone: 661-399-2901