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General NPI Number Information
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NPI Number | 1679654719
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Entity Type | Organization
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Legal Business Name | HEALTH QUEST PHARMACY INC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 911 OAK PARK BLVD #101
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City | PISMO BEACH
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State | CA
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Zip | 93449
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Country | US
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Telephone | 805-489-0888
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Fax | 805-489-0288
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Provider Business Mailing Address
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Address Line | 911 OAK PARK BLVD #101
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City | PISMO BEACH
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State | CA
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Zip | 93449
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Country | US
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Telephone | 805-489-0888
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Fax | 805-489-0288
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL STEPHEN KYLE
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Credential |
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Telephone | 805-489-0888
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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 | PHY47165
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY47165
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHY47165
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY47165
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY50613
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PHY50613
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY50613
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License Number State | CA
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