Organization
BAIDEN GROUP INC
Active
Other names
ACTON VALE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMMA AMIHYIA (OWNER)
(661) 269-9911
Entity
Organization
Contact information
Practice address
3630 SMITH AVE, STE A, ACTON, CA 93510-2500
(661) 269-9911
(661) 269-9915
Mailing address
3630 SMITH AVE, STE A, ACTON, CA 93510-2500
(661) 269-9911
(661) 269-9915
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY50825
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124393616
—
CA
01
—
2134360
PK
—
Enumeration date
03/15/2012
Last updated
04/08/2022
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