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General NPI Number Information
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NPI Number | 1386226306
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Entity Type | Organization
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Legal Business Name | SPECIALTY PHARMA SAI INC
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 4153B UNIVERSITY AVE, SUITE B
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City | SAN DIEGO
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State | CA
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Zip | 92105-1421
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Country | US
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Telephone | 949-590-0056
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Fax | 619-333-2525
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Provider Business Mailing Address
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Address Line | 15642 SAND CANYON AVE UNIT 53871
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City | IRVINE
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State | CA
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Zip | 92619-5430
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Country | US
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Telephone | 949-590-0056
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Fax | 619-333-2525
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIJAYA LAXMI
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Credential |
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Telephone | 949-590-0056
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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 |
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