# HALLERS LTC PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Haller's LTC Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366598161
- **Authorized official:** AARONDEEP BASRAI (CEO)
- **Authorized official phone:** (510) 793-5096

## Contact information

- **Practice address:** 4067 PERALTA BLVD, FREMONT, CA 94536-4849
- **Practice address phone:** (510) 793-5096
- **Practice address fax:** (510) 745-9950
- **Mailing address:** 4067 PERALTA BLVD, FREMONT, CA 94536-4849
- **Mailing address phone:** (510) 793-5096
- **Mailing address fax:** (510) 745-9950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 08/07/2019