Organization
TARGET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA GREKOVA (REGISTERED PHARMACIST)
(323) 854-7646
Entity
Organization
Contact information
Practice address
3150 BUSINESS PARK DR, VISTA, CA 92081-8520
(760) 208-6111
Mailing address
3631 GLENEAGLES DR, TARZANA, CA 91356-5620
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
73562
CA
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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