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General NPI Number Information
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NPI Number | 1366598161
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Entity Type | Organization
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Legal Business Name | HALLERS LTC PHARMACY, INC.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 4067 PERALTA BLVD
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City | FREMONT
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State | CA
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Zip | 94536-4849
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Country | US
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Telephone | 510-793-5096
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Fax | 510-745-9950
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Provider Business Mailing Address
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Address Line | 4067 PERALTA BLVD
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City | FREMONT
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State | CA
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Zip | 94536-4849
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Country | US
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Telephone | 510-793-5096
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Fax | 510-745-9950
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Authorized Official
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Title or Position | CEO
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Name | AARONDEEP BASRAI
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Credential |
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Telephone | 510-793-5096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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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