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General NPI Number Information
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NPI Number | 1548466410
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Entity Type | Organization
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Legal Business Name | QUALICARE
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9613 ARROW RTE STE K BLDG 3
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4552
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Country | US
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Telephone | 909-484-2300
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Fax | 909-484-2332
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Provider Business Mailing Address
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Address Line | 9613 ARROW RTE STE K BLDG 3
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4552
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Country | US
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Telephone | 909-484-2300
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Fax | 909-484-2332
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Authorized Official
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Title or Position | PIC
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Name | MRS. MARLYN MANIAOL
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Credential |
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Telephone | 909-484-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 48361
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License Number State | CA
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