Healthcare Provider Details

I. General information

NPI: 1629314109
Provider Name (Legal Business Name): STERLING PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 KUEHNER DR SUITE 110
SIMI VALLEY CA
93063-3900
US

IV. Provider business mailing address

2315 KUEHNER DR SUITE 110
SIMI VALLEY CA
93063-3900
US

V. Phone/Fax

Practice location:
  • Phone: 866-407-4415
  • Fax:
Mailing address:
  • Phone: 866-407-4415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number51201
License Number StateCA

VIII. Authorized Official

Name: JOHN ABASSIAN
Title or Position: PRESIDENT
Credential:
Phone: 866-407-4415