Organization
SALEH PHARMACY, INC.
Active
Other names
Wagner Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED SALEH (CEO/CFO/SEC./DIR.)
(510) 924-6688
Entity
Organization
Contact information
Practice address
1224 EAST MCFADDEN AVE., SANTA ANA, CA 92705
(714) 547-3590
(714) 547-5977
Mailing address
1224 EAST MCFADDEN AVE., SANTA ANA, CA 92705
(714) 547-3590
(714) 547-5977
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY35724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0597596
NABP # OR NCPDP #
CA
01
—
954218320
FEDERAL TAX ID #
CA
05
—
PHA357240
—
CA
01
—
PHY35724
STATE LICENSE
CA
Enumeration date
07/22/2006
Last updated
07/05/2023
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