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General NPI Number Information
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NPI Number | 1356619894
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Entity Type | Organization
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Legal Business Name | BASSO PHARMACY, INC
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 08/13/2014
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Provider Practice Location Address
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Address Line | 3901 LAS POSAS RD # 101
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City | CAMARILLO
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State | CA
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Zip | 93010-1501
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Country | US
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Telephone | 805-419-2686
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Fax | 805-419-2687
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Provider Business Mailing Address
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Address Line | 3901 LAS POSAS RD # 101
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City | CAMARILLO
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State | CA
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Zip | 93010-1501
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Country | US
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Telephone | 805-419-2686
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Fax | 805-419-2687
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. JASMINE YAS RAZEGHI
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Credential | PHARM.D
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Telephone | 805-419-2686
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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 |
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License Number State | CA
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