Organization
SUPERIOR CARE PHARMACY INC
Active
Other names
SUPERIOR CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK M ISHAQUE (CFO)
(619) 785-3993
Entity
Organization
Contact information
Practice address
161 EAST MAIN STREET, SUITE 104, LA MESA, CA 91942-1534
(619) 785-3993
(844) 637-2447
Mailing address
161 EAST MAIN STREET, SUITE 104, LA MESA, CA 91942-1534
(619) 785-3993
(844) 637-2447
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY 50311
CA
3336C0003X
Community/Retail Pharmacy
PHY 50311
CA
3336L0003X
Long Term Care Pharmacy
Primary
PHY 50311
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY 50311
RETAIL PHARMACY PERMIT
CA
Enumeration date
05/24/2010
Last updated
02/09/2016
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