MEDICARE: BLUE ZONE RX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1063342913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE ZONE RX

Provider Business Mailing Address
First Line	:	755 JAMACHA RD
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-3202
Country	:	US
Telephone Number	:	619-499-7841
Fax Number	:	619-312-1168

Provider Business Practice Location Address
First Line	:	755 JAMACHA RD
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-3202
Country	:	US
Telephone Number	:	619-499-7841
Fax Number	:	619-312-1168

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	FARAH ALAZIZ
Credential	:	RPH
Telephone Number	:	619-499-7841

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “BLUE ZONE RX ” Practice Location

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