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General NPI Number Information
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NPI Number | 1376054411
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Entity Type | Organization
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Legal Business Name | NEW LEAF PHARMACY INC
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 4433 MING AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93309-4817
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Country | US
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Telephone | 661-885-9707
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Fax | 661-885-9709
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Provider Business Mailing Address
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Address Line | 4433 MING AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93309-4817
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Country | US
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Telephone | 661-885-9707
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Fax | 661-885-9709
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. BASSEM MESSIHA
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Credential | RPH
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Telephone | 626-502-3994
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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 | 55707
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License Number State | CA
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