Organization
ASR HEALTH INC.
Active
Other names
QUEENS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SRINVASA RAO KANDRU (DIRECTOR)
(760) 946-4700
Entity
Organization
Contact information
Practice address
18522 US HIGHWAY 18, STE 103, APPLE VALLEY, CA 92307-2321
(760) 946-4700
(760) 946-1901
Mailing address
12677 HESPERIA ROAD, SUITE 180, VICTORYVILLE, CA 92395
(760) 962-1200
(760) 962-1222
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112986
PK
—
05
—
PHY57282
—
CA
Enumeration date
11/13/2007
Last updated
10/27/2020
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