Healthcare Provider Details

I. General information

NPI: 1144400706
Provider Name (Legal Business Name): BOIES MEDICAL CENTER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 FAIR OAKS BLVD STE #E
CARMICHAEL CA
95608-4872
US

IV. Provider business mailing address

6110 FAIR OAKS BLVD. STE #E
CARMICHAEL CA
95608-4873
US

V. Phone/Fax

Practice location:
  • Phone: 916-978-0866
  • Fax: 877-914-2220
Mailing address:
  • Phone: 916-978-0856
  • Fax: 877-914-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number52538
License Number StateCA

VIII. Authorized Official

Name: MR. TAREQ AHMAD AL MUGHAZZEZ
Title or Position: CEO
Credential: R.PH.
Phone: 650-743-3235