Healthcare Provider Details
I. General information
NPI: 1700677929
Provider Name (Legal Business Name): TEHACHAPI HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20221 VALLEY BLVD UNIT 1
TEHACHAPI CA
93561
US
IV. Provider business mailing address
14813 BROMSHIRE ST
BAKERSFIELD CA
93311-8424
US
V. Phone/Fax
- Phone: 661-431-4915
- Fax:
- Phone: 661-431-4915
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
FRIGILLANA
Title or Position: DIRECTOR
Credential:
Phone: 661-431-4915