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General NPI Number Information
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NPI Number | 1699227983
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Entity Type | Organization
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Legal Business Name | LANDMARK PHARMA INC
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 1113 ALTA AVE STE 100
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City | UPLAND
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State | CA
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Zip | 91786-2804
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Country | US
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Telephone | 909-360-8352
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Fax | 909-360-8372
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Provider Business Mailing Address
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Address Line | 1113 ALTA AVE STE 100
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City | UPLAND
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State | CA
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Zip | 91786-2804
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Country | US
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Telephone | 909-360-8352
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Fax | 909-360-8372
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Authorized Official
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Title or Position | PRESIDENT, AO
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Name | JINESH PATEL
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Credential |
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Telephone | 714-270-7432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 | 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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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 55396
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License Number State | CA
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