# BROOKHURST DRUG INC TERRY BOTTORFF PRES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Druggist \#3
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063457638
- **Authorized official:** MR. TERRY M BOTTORFF RPH (PRESIDENT)
- **Authorized official phone:** (714) 963-5512

## Contact information

- **Practice address:** 21421 BROOKHURST ST, HUNTINGTON BEACH, CA 92646-7354
- **Practice address phone:** (714) 963-4552
- **Practice address fax:** (714) 963-1705
- **Mailing address:** 21421 BROOKHURST ST, HUNTINGTON BEACH, CA 92646-7354
- **Mailing address phone:** (714) 963-4552
- **Mailing address fax:** (714) 963-1705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PHY34032 | CA | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 10/30/2018