Organization
BROOKHURST DRUG INC TERRY BOTTORFF PRES
Active
Other names
The Druggist #3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY M BOTTORFF RPH (PRESIDENT)
(714) 963-5512
Entity
Organization
Contact information
Practice address
21421 BROOKHURST ST, HUNTINGTON BEACH, CA 92646-7354
(714) 963-4552
(714) 963-1705
Mailing address
21421 BROOKHURST ST, HUNTINGTON BEACH, CA 92646-7354
(714) 963-4552
(714) 963-1705
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PHY34032
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA169070
—
CA
Enumeration date
06/18/2006
Last updated
10/30/2018
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