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Organization
WESTERN PHARMACY GROUP LLC
Active
Organization
WESTERN PHARMACY GROUP LLC
Active
Other names
MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FARIS (CEO)
(360) 220-4818
Entity
Organization
Contact information
Practice address
610 GATEWAY CENTER WAY, STE A, SAN DIEGO, CA 92102-4533
(619) 262-4373
(619) 263-1557
Mailing address
851 COHO WAY STE 312, BELLINGHAM, WA 98225-2066
(360) 685-4263
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
55904
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176004
PK
—
Enumeration date
02/14/2011
Last updated
07/19/2018
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