Healthcare Provider Details

I. General information

NPI: 1093558769
Provider Name (Legal Business Name): ALMA CARE PHARMACY A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15475 SENECA RD STE C
VICTORVILLE CA
92392-2299
US

IV. Provider business mailing address

15475 SENECA RD STE C
VICTORVILLE CA
92392-2299
US

V. Phone/Fax

Practice location:
  • Phone: 760-477-0229
  • Fax: 442-204-1344
Mailing address:
  • Phone: 760-477-0229
  • Fax: 442-204-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AARON ANTONIO SOLIS-ALVARENGA
Title or Position: OWNER
Credential: PHARMD
Phone: 760-477-0229