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Organization
IRVINE SAND CANYON PHARMACY INC
Active
Organization
IRVINE SAND CANYON PHARMACY INC
Active
Other names
TOWN CENTER COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MORT FARINA R.PH. (PRESIDENT)
(310) 880-2537
Entity
Organization
Contact information
Practice address
72624 EL PASEO, SUITE A1, PALM DESERT, CA 92260-3309
(760) 341-3984
(760) 341-4954
Mailing address
8 SCARBOROUGH WAY, ROOM 92270, RANCHO MIRAGE, CA 92270-1624
(310) 880-2537
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
99148
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44047
PHARMACY LICENSE
CA
Enumeration date
02/28/2007
Last updated
08/22/2020
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