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General NPI Number Information
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NPI Number | 1073300448
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Entity Type | Organization
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Legal Business Name | ALPHA OMEGA PHARMACY INC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 10500 MAGNOLIA AVE UNIT D
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City | ANAHEIM
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State | CA
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Zip | 92804-5817
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Country | US
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Telephone | 714-788-5541
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Fax | 714-788-5668
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Provider Business Mailing Address
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Address Line | 10500 MAGNOLIA AVE UNIT D
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City | ANAHEIM
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State | CA
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Zip | 92804-5817
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Country | US
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Telephone | 714-788-5541
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Fax | 714-788-5668
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Authorized Official
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Title or Position | OWNER
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Name | FADY TAKLA
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Credential | RPH
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Telephone | 323-231-9307
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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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