Healthcare Provider Details

I. General information

NPI: 1972345346
Provider Name (Legal Business Name): CARPHARMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NEWBURY RD STE 100
NEWBURY PARK CA
91320-6436
US

IV. Provider business mailing address

1000 NEWBURY RD STE 100
NEWBURY PARK CA
91320-6436
US

V. Phone/Fax

Practice location:
  • Phone: 805-375-4050
  • Fax:
Mailing address:
  • Phone: 805-375-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CASSRA MINAI
Title or Position: CEO/SEC./DIR.
Credential:
Phone: 949-735-2423