# TUSTIN PREMIER PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457183733
- **Authorized official:** MARY IBRAHIM (PIC)
- **Authorized official phone:** (714) 790-4085

## Contact information

- **Practice address:** 217 S TUSTIN ST, ORANGE, CA 92866-2321
- **Practice address phone:** (714) 790-4085
- **Mailing address:** 217 S TUSTIN ST, ORANGE, CA 92866-2321
- **Mailing address phone:** (714) 790-4085

## Taxonomy

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

## Other

- **Enumeration date:** 08/15/2024
- **Last updated:** 08/15/2024