Organization
D J A M INC
Active
Other names
Phelan Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JANET ATTIA (CEO)
(760) 980-0920
Entity
Organization
Contact information
Practice address
3936 PHELAN RD STE A1, PHELAN, CA 92371-4142
(760) 706-0130
(760) 706-0131
Mailing address
9778 SVL BOX, VICTORVILLE, CA 92395-5142
(760) 706-0130
(760) 706-0131
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
54488
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165868
PK
—
Enumeration date
10/23/2016
Last updated
03/17/2017
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