Organization
ASHAPURIMAA INC
Active
Other names
Sierra San Antonio Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY MEHTA RPH (PRESIDENT)
(909) 574-9620
Entity
Organization
Contact information
Practice address
16465 SIERRA LAKES PKWY, STE 110, FONTANA, CA 92336-1242
(909) 574-9620
(909) 574-9621
Mailing address
16465 SIERRA LAKES PKWY, STE 110, FONTANA, CA 92336-1242
(909) 574-9620
(909) 574-9621
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275627671
—
CA
01
—
5622104
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/03/2006
Last updated
10/23/2015
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