MEDICARE: PEOPLES PHARMACY

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
2	3336C0003X	Community/Retail Pharmacy	PHY47303	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2113794	OTHER		PK

General Provider Information

NPI Number	:	1740295385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEOPLES PHARMACY

Provider Business Mailing Address
First Line	:	31951 DOVE CANYON DR
Second Line	:	STE F
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3749
Country	:	US
Telephone Number	:	949-713-9400
Fax Number	:	949-713-9494

Provider Business Practice Location Address
First Line	:	31951 DOVE CANYON DR
Second Line	:	STE F
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3749
Country	:	US
Telephone Number	:	949-713-9400
Fax Number	:	949-713-9494

Authorized Official
Title or Position	:	PIC
Name	:	RASHMI MEDIRATTA
Credential	:	RPH
Telephone Number	:	949-713-9400

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	04/21/2016

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Directions to “PEOPLES PHARMACY ” Practice Location

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