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Organization
IMPERIAL BEACH PHARMACY LLC
Active
Organization
IMPERIAL BEACH PHARMACY LLC
Active
Other names
IMPERIAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANT AMRUTLAL KOYANI PHARMD (MEMBER)
(619) 343-0095
Entity
Organization
Contact information
Practice address
1530 PALM AVE, SAN DIEGO, CA 92154-1016
(619) 343-0095
(619) 830-4590
Mailing address
1530 PALM AVE, SAN DIEGO, CA 92154-1016
(619) 343-0095
(619) 830-4590
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Enumeration date
02/08/2024
Last updated
10/22/2024
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