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General NPI Number Information
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NPI Number | 1578646626
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Entity Type | Organization
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Legal Business Name | FL & CO
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 400 NEWPORT CENTER DR SUITE 106
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7601
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Country | US
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Telephone | 949-719-3707
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Fax | 949-719-3713
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Provider Business Mailing Address
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Address Line | PO BOX 54468
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City | IRVINE
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State | CA
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Zip | 92619-4468
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Country | US
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Telephone | 949-719-3707
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Fax | 949-719-3713
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BRIAN LYN
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Credential | PHARMD
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Telephone | 949-719-3707
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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 | PHY48317
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5998960001
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License Number State | CA
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Taxonomy #3
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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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