Organization
ENTAG INC
Active
Other names
Medicine Care Pharmacy II
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD FATHIE (CFO)
(619) 200-3927
Entity
Organization
Contact information
Practice address
1685 E MAIN ST, STE 101, EL CAJON, CA 92021-5225
(619) 383-2757
(619) 956-3136
Mailing address
1685 E MAIN ST, STE 101, EL CAJON, CA 92021-5225
(619) 383-2757
(858) 429-5780
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY49784
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001246
PK
—
05
—
3354331
—
CA
05
—
PHA433180
—
CA
Enumeration date
11/15/2006
Last updated
08/10/2016
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