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General NPI Number Information
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NPI Number | 1508334335
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Entity Type | Organization
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Legal Business Name | QUIRE PHARMACY OF ANAHEIM, LLC
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 24422 AVENIDA DE LA CARLOTA STE 300
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3628
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Country | US
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Telephone | 800-592-7174
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 W BELMONT AVE STE 320
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City | CHICAGO
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State | IL
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Zip | 60657-5785
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Country | US
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Telephone | 708-297-1330
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW CUNNINGHAM
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Credential |
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Telephone | 708-297-1330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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