=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851304570
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A & R PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2006
-----------------------------------------------------
Last Update Date | 07/17/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23665 MOULTON PKWY STE A
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653-1937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-768-3784
-----------------------------------------------------
Fax | 949-768-1359
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23665 MOULTON PKWY STE A
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653-1937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-768-3784
-----------------------------------------------------
Fax | 949-768-1359
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | AMIT HASOLKAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 949-768-3784
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY47488
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------