Healthcare Provider Details

I. General information

NPI: 1255244075
Provider Name (Legal Business Name): NOVA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 BROADWAY
EL CAJON CA
92021-5811
US

IV. Provider business mailing address

1303 BROADWAY
EL CAJON CA
92021-5811
US

V. Phone/Fax

Practice location:
  • Phone: 619-499-7393
  • Fax: 619-499-7471
Mailing address:
  • Phone: 619-499-7393
  • Fax: 619-499-7471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SARAH GARGOR
Title or Position: OWNER
Credential:
Phone: 619-844-9069