Organization
AFP DRUG STORE INC
Active
Organization
AFP DRUG STORE INC
Active
Other names
A FAMILY PHARMACY APPLE VALLEY
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS TEKELE PHARM D (PRESIDENT)
(760) 242-5452
Entity
Organization
Contact information
Practice address
15863 KASOTA RD, STE C, APPLE VALLEY, CA 92307-4507
(760) 242-5452
(760) 242-8617
Mailing address
PO BOX 900, VICTORVILLE, CA 92393-0900
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
51090
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5613333
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA46639
—
CA
Enumeration date
08/30/2006
Last updated
01/18/2013
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