Organization
IMGRX SLO, INC.
Active
Parent organization
IMGRX SLO, INC.
Other names
CHC Pharmacy SLO
Organization subpart
Yes
Provider details
NPI number
Legal business name
IMGRX SLO, INC.
Authorized official
MICHAEL BROWN (VICE PRESIDENT, MANAGED SERVICES)
(281) 749-4764
Entity
Organization
Contact information
Practice address
77 CASA ST STE 205, SAN LUIS OBISPO, CA 93405-5803
(512) 596-2930
(805) 269-1593
Mailing address
13651 DUBLIN CT, STAFFORD, TX 77477-4317
(281) 749-4000
(614) 652-0326
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164368
PK
—
Enumeration date
08/03/2016
Last updated
09/15/2022
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