Organization
PHAST PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYMAN MOHAMED (OWNER)
(661) 578-6500
Entity
Organization
Contact information
Practice address
1121 W COLUMBUS ST, BAKERSFIELD, CA 93301-1105
(661) 578-6500
Mailing address
1121 W COLUMBUS ST, BAKERSFIELD, CA 93301-1105
(661) 578-6500
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100157328
—
CA
Enumeration date
08/31/2020
Last updated
08/31/2020
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