Healthcare Provider Details
I. General information
NPI: 1568963312
Provider Name (Legal Business Name): PHARMEDQUEST PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2018
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3020 SATURN ST STE 100
BREA CA
92821-6262
US
IV. Provider business mailing address
10604 COURSEY BLVD
BATON ROUGE LA
70816-4015
US
V. Phone/Fax
- Phone: 877-362-9778
- Fax: 714-364-1448
- Phone: 714-599-8181
- Fax: 714-599-8242
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 55894 |
| License Number State | CA |
VIII. Authorized Official
Name: MS.
KRISTEN
GURLEY
Title or Position: VP LEGAL AFFAIRS
Credential:
Phone: 469-592-2011