Healthcare Provider Details

I. General information

NPI: 1154436103
Provider Name (Legal Business Name): FARMACIA REMEDIOS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3351 INTERNATIONAL BLVD
OAKLAND CA
94601-3005
US

IV. Provider business mailing address

PO BOX 9830
SALT LAKE CITY UT
84109-9830
US

V. Phone/Fax

Practice location:
  • Phone: 510-261-8334
  • Fax: 510-261-5400
Mailing address:
  • Phone: 877-540-4748
  • Fax: 801-716-4872

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 NumberPHY46651
License Number StateCA

VIII. Authorized Official

Name: BEN SINGER
Title or Position: COO
Credential:
Phone: 415-377-5525