Healthcare Provider Details

I. General information

NPI: 1154961837
Provider Name (Legal Business Name): PHARMEDQUEST PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45104 10TH ST W STE A
LANCASTER CA
93534-2310
US

IV. Provider business mailing address

10604 COURSEY BLVD
BATON ROUGE LA
70816-4015
US

V. Phone/Fax

Practice location:
  • Phone: 661-485-7528
  • Fax:
Mailing address:
  • Phone: 714-599-8181
  • Fax: 714-599-8242

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 Number
License Number State

VIII. Authorized Official

Name: CARL CODY COLQUITT
Title or Position: CFO
Credential:
Phone: 469-592-2011