Organization
FALLBROOK PHARMACY INC II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CLEMENTS (CFO)
(760) 728-3182
Entity
Organization
Contact information
Practice address
343 E ALVARADO ST, STE B, FALLBROOK, CA 92028-2966
(760) 728-3182
(760) 728-2398
Mailing address
343 E ALVARADO ST, STE B, FALLBROOK, CA 92028-2966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY39905
CA
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5621998
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/20/2006
Last updated
09/11/2025
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