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General NPI Number Information
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NPI Number | 1689454605
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Entity Type | Organization
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Legal Business Name | ASCENDANT PHARMACY INCORPORATED
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 8125 RONSON RD STE G
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City | SAN DIEGO
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State | CA
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Zip | 92111-2010
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Country | US
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Telephone | 858-987-1020
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Fax | 858-987-1022
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Provider Business Mailing Address
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Address Line | 8125 RONSON RD STE G
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City | SAN DIEGO
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State | CA
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Zip | 92111-2010
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Country | US
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Telephone | 858-987-1020
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Fax | 858-987-1022
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | MR. GAVIN JO LEE
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Credential |
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Telephone | 858-775-1827
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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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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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