# ROMEO V VILLANUEVA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAJESTIC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770529778
- **Authorized official:** ROMEO VILLANUEVA (OWNER)
- **Authorized official phone:** (619) 280-1254

## Contact information

- **Practice address:** 4456 VANDEVER AVE, STE 5, SAN DIEGO, CA 92120-3320
- **Practice address phone:** (619) 280-1254
- **Practice address fax:** (619) 280-1255
- **Mailing address:** 4456 VANDEVER AVE, STE 5, SAN DIEGO, CA 92120-3320
- **Mailing address phone:** (619) 280-1254
- **Mailing address fax:** (619) 280-1255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHY44529 | CA | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 09/22/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1992856 | PK | — |
| 05 | — | PHA445290 | — | CA |