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Organization
UPAS PHARMACY INC
Active
Organization
UPAS PHARMACY INC
Active
Other names
UPAS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MCKILLIP (PRESIDENT/PHARMACIST)
(619) 297-1677
Entity
Organization
Contact information
Practice address
3332 3RD AVE, SAN DIEGO, CA 92103-5618
(619) 297-1677
(619) 297-1171
Mailing address
3332 3RD AVE, SAN DIEGO, CA 92103-5618
(619) 297-1677
(619) 297-1171
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY36112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000614
PK
—
05
—
PHA361120
—
CA
Enumeration date
08/10/2006
Last updated
04/09/2014
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