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General NPI Number Information
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NPI Number | 1306944483
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Entity Type | Organization
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Legal Business Name | VISTA PHARMACIES INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 436 S RIVERSIDE AVE
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City | RIALTO
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State | CA
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Zip | 92376-6523
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Country | US
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Telephone | 909-875-7260
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Fax | 909-875-7265
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Provider Business Mailing Address
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Address Line | 436 S RIVERSIDE AVE
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City | RIALTO
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State | CA
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Zip | 92376-6523
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Country | US
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Telephone | 626-825-3899
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Fax | 909-598-3117
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. THOMAS POSIN
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Credential |
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Telephone | 626-825-3899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY45536
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License Number State | CA
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