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Organization
WASCO VALLEY PHARMACY INC
Active
Organization
WASCO VALLEY PHARMACY INC
Active
Other names
WASCO MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
MORRIS LWENYA RPH (PIC AND OWNER)
(661) 758-1123
Entity
Organization
Contact information
Practice address
1129 7TH ST, WASCO, CA 93280-1819
(661) 758-1123
(661) 759-2800
Mailing address
PO BOX 1257, WASCO, CA 93280-8157
(661) 758-1123
(661) 759-2800
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47090
CA
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615325
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA470900
—
CA
Enumeration date
08/10/2006
Last updated
09/13/2011
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