# DEL SUR PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairbanks Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215434873
- **Authorized official:** BERNARD GRAMLICH (CEO)
- **Authorized official phone:** (858) 759-6625

## Contact information

- **Practice address:** 16089 SAN DIEGUITO RD \# H102, RANCHO SANTA FE, CA 92067-9529
- **Practice address phone:** (858) 759-6625
- **Practice address fax:** (858) 759-6729
- **Mailing address:** PO BOX 9227, RANCHO SANTA FE, CA 92067-4227
- **Mailing address phone:** (858) 759-6625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 55594 | CA | Yes |

## Other

- **Enumeration date:** 04/10/2018
- **Last updated:** 04/10/2018