Organization
TDSM INC
Active
Other names
VIDA DRUG STORE & PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NARIMAN ESHAK (CEO)
(909) 983-0999
Entity
Organization
Contact information
Practice address
437 N EUCLID AVE, SUITE B, ONTARIO, CA 91762-3456
(909) 983-0999
(909) 983-0888
Mailing address
437 N EUCLID AVE, SUITE B, ONTARIO, CA 91762-3456
(909) 983-0999
(909) 983-0888
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 49856
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093802514
—
CA
Enumeration date
10/06/2006
Last updated
12/13/2022
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