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General NPI Number Information
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NPI Number | 1972505592
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Entity Type | Organization
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Legal Business Name | CBC PROFESSIONAL PHARMACY INC
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 WESTERN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1356
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Country | US
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Telephone | 909-887-6359
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Fax | 909-887-9890
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Provider Business Mailing Address
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Address Line | 2095 W ARROW RTE
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City | UPLAND
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State | CA
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Zip | 91786-4210
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Country | US
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Telephone | 909-982-4843
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Fax | 909-982-4967
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARLA L FREED
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Credential |
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Telephone | 909-982-4843
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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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