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Organization
WAGNER DRUG CORPORATION
Active
Organization
WAGNER DRUG CORPORATION
Active
Other names
Central Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES LANIER WAGNER RPH (PRESIDENT)
(619) 435-4171
Entity
Organization
Contact information
Practice address
1106 ORANGE AVE, CORONADO, CA 92118-3407
(619) 435-4171
(619) 435-1926
Mailing address
1106 ORANGE AVE, CORONADO, CA 92118-3407
(619) 435-4171
(619) 435-1926
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24978
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY46037
PHARMACY PERMIT
CA
Enumeration date
05/09/2007
Last updated
03/07/2023
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