Organization
SENIOR CARE PHARMACY SERVICES FAIRFIELD INC
Active
Other names
Senior Care Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIT BANERJEE (CEO)
(714) 891-1800
Entity
Organization
Contact information
Practice address
4950 FULTON DR, SUITE A AND B, FAIRFIELD, CA 94534-1615
(707) 673-9800
(707) 673-9900
Mailing address
PO BOX 27458, ANAHEIM, CA 92809-0115
(714) 891-1800
(714) 891-1102
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY50619
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5641332
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/27/2011
Last updated
02/20/2013
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