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General NPI Number Information
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NPI Number | 1265521819
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Entity Type | Organization
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Legal Business Name | M E C PHARMACY SERVICES INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 103 E HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-3603
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Country | US
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Telephone | 909-882-3353
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Fax | 909-882-7849
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Provider Business Mailing Address
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Address Line | PO BOX 2871
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City | SAN BERNARDINO
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State | CA
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Zip | 92406-2871
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Country | US
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Telephone | 909-882-3353
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Fax | 909-882-7849
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Authorized Official
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Title or Position | CEO
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Name | ERIC CLARK
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Credential |
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Telephone | 909-882-3353
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY53469
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License Number State | CA
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