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General NPI Number Information
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NPI Number | 1720449267
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Entity Type | Organization
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Legal Business Name | HOT SPRINGS PHARMACY INC
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 13313 PALM DR STE A
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City | DESERT HOT SPRINGS
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State | CA
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Zip | 92240-5980
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Country | US
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Telephone | 760-251-2222
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Fax | 760-251-1200
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Provider Business Mailing Address
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Address Line | 13313 PALM DR STE A
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City | DESERT HOT SPRINGS
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State | CA
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Zip | 92240-5980
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Country | US
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Telephone | 760-251-2222
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Fax | 760-251-1200
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Authorized Official
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Title or Position | CEO / PIC / OWNER / AO
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Name | MARKO FAM
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Credential | RPH
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Telephone | 760-251-2222
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | PHY54379
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License Number State | CA
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