Healthcare Provider Details

I. General information

NPI: 1255342846
Provider Name (Legal Business Name): ALS PHARMACY AND COMPOUNDING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 MAIN ST
CAMBRIA CA
93428-3018
US

IV. Provider business mailing address

2222 MAIN ST
CAMBRIA CA
93428-3018
US

V. Phone/Fax

Practice location:
  • Phone: 805-927-7283
  • Fax: 805-927-2955
Mailing address:
  • Phone: 805-927-7283
  • Fax: 805-927-2955

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 NumberPHY51150
License Number StateCA

VIII. Authorized Official

Name: ALVIN FERRER
Title or Position: CEO
Credential: PHARMD
Phone: 805-909-9027