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General NPI Number Information
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NPI Number | 1235558859
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Entity Type | Organization
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Legal Business Name | ASBAC PHARMACY DBA MED CARE PHARMACY
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 161 THUNDER DR SUITE #100
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City | VISTA
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State | CA
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Zip | 92083-6016
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Country | US
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Telephone | 760-758-7650
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Fax | 760-758-8228
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Provider Business Mailing Address
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Address Line | 161 THUNDER DR SUITE #100
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City | VISTA
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State | CA
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Zip | 92083-6016
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Country | US
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Telephone | 760-758-7650
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Fax | 760-758-8228
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH RAYMOND DEVINS
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Credential | RPH.
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Telephone | 760-758-7650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHA482370
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License Number State | CA
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