Organization
NASIBADARA, INC
Active
Other names
El Toro Pharmacy, El Toro Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEWART EDINGTON (OWNER)
(954) 818-6813
Entity
Organization
Contact information
Practice address
23665 MOULTON PKWY STE A&C, LAGUNA HILLS, CA 92653-1937
(949) 586-3664
(949) 580-1723
Mailing address
23665 MOULTON PKWY, SUITE A & C, LAGUNA HILLS, CA 92653-1937
(949) 586-3664
(949) 580-1723
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY55801
CA
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997867
PK
—
05
—
PHA44808
—
CA
Enumeration date
09/12/2006
Last updated
01/24/2018
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