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Organization
HERITAGE COMPOUNDING PHARMACY
Active
Organization
HERITAGE COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYLVIA A MOORE PHARM.D. (PHARMACIST IN CHARGE)
(714) 579-1636
Entity
Organization
Contact information
Practice address
2903 SATURN ST STE A, BREA, CA 92821-6259
(714) 579-1636
(714) 579-1682
Mailing address
30802 COAST HWY, SPC. D8, LAGUNA BEACH, CA 92651-4207
(949) 235-0343
(714) 579-1682
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22225
CA
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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