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Organization
VISTA CARE PHARMACY INC
Active
Organization
VISTA CARE PHARMACY INC
Active
Other names
VISTA CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMIR A RAO (PRESIDENT/OWNER)
(760) 843-7000
Entity
Organization
Contact information
Practice address
12351 MARIPOSA RD # 11, VICTORVILLE, CA 92395-6013
(760) 843-7000
(760) 843-7900
Mailing address
12351 MARIPOSA RD # 11, VICTORVILLE, CA 92395-6013
(760) 843-7000
(760) 843-7900
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53478
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY 53478
BOARD OF PHARMACY LICENSE
CA
Enumeration date
08/26/2015
Last updated
08/26/2015
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