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General NPI Number Information
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NPI Number | 1730239054
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Entity Type | Organization
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Legal Business Name | ANB PHARMACY SVC INC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 5142 N COMMERCE AVE UNIT C
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City | MOORPARK
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State | CA
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Zip | 93021-7132
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Country | US
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Telephone | 805-532-1222
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Fax | 805-532-1208
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Provider Business Mailing Address
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Address Line | 5142 N COMMERCE AVE UNIT C
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City | MOORPARK
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State | CA
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Zip | 93021-7132
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Country | US
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Telephone | 805-532-1222
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Fax | 805-532-1208
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Authorized Official
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Title or Position | PIC
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Name | CHARLINE VAN GILDER
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Credential | RPH
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Telephone | 805-532-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY46525
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License Number State | CA
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