# SUPERIOR CARE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUPERIOR CARE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295054716
- **Authorized official:** MR. DEREK M ISHAQUE (CFO)
- **Authorized official phone:** (619) 785-3993

## Contact information

- **Practice address:** 161 EAST MAIN STREET, SUITE 104, LA MESA, CA 91942-1534
- **Practice address phone:** (619) 785-3993
- **Practice address fax:** (844) 637-2447
- **Mailing address:** 161 EAST MAIN STREET, SUITE 104, LA MESA, CA 91942-1534
- **Mailing address phone:** (619) 785-3993
- **Mailing address fax:** (844) 637-2447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | PHY 50311 | CA | — |
| 3336C0003X | Community/Retail Pharmacy | PHY 50311 | CA | — |
| 3336L0003X | Long Term Care Pharmacy | PHY 50311 | CA | Yes |

## Other

- **Enumeration date:** 05/24/2010
- **Last updated:** 02/09/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PHY 50311 | RETAIL PHARMACY PERMIT | CA |