Organization
FOREVER YOUNG PHARMACY
Active
Other names
Forever Young Pharmacy, Forever Young Rx
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANE DAVID FREDERICKSEN PHARM. D. (OWNER)
(714) 757-7584
Entity
Organization
Contact information
Practice address
6351 CORTE DEL ABETO STE 111, CARLSBAD, CA 92011-1429
(714) 757-7584
Mailing address
6351 CORTE DEL ABETO STE 111, CARLSBAD, CA 92011-1429
(714) 757-7584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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