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Organization
COMMUNITY PHARMACY
Active
Organization
COMMUNITY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEL CARRICO (OWNER PHARMACIST)
(760) 355-2863
Entity
Organization
Contact information
Practice address
117 N IMPERIAL AVE, IMPERIAL, CA 92251-1262
(760) 355-2863
Mailing address
PO BOX 638, IMPERIAL, CA 92251-0638
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHY39518
CA
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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