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Organization

DESERT PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN PAUL TEAGUE PHARM.D. (CEO/PRESIDENT)
(760) 997-7800
Entity
Organization

Contact information

Practice address
1560 S IMPERIAL AVE, EL CENTRO, CA 92243-4241
(760) 997-7800
(760) 997-7801
Mailing address
1560 S IMPERIAL AVE, EL CENTRO, CA 92243-4241
(760) 997-7800
(760) 997-7801

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
55856
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5665027
NABP
CA
01
57741
PHARMACY LICENSE CALIFORNIA BOARD OF PHARMACY
CA
05
PHY2154641
CA
Enumeration date
12/04/2017
Last updated
01/31/2022
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