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General NPI Number Information
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NPI Number | 1003374554
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Entity Type | Organization
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Legal Business Name | ELDAHMY WELLNESS PHARMACY INC.
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 1985 NATIONAL AVE
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City | SAN DIEGO
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State | CA
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Zip | 92113-2154
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Country | US
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Telephone | 619-331-1111
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Fax | 619-331-1122
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Provider Business Mailing Address
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Address Line | 1985 NATIONAL AVE STE 1103
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City | SAN DIEGO
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State | CA
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Zip | 92113-2155
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Country | US
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Telephone | 619-331-1111
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | AHMED ELDAHMY
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Credential | PHARMD
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Telephone | 619-869-5895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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