Organization
KBC PHARMACY INC
Active
Other names
986 Pharmacy #8024
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE PATEL PHARM.D. (CEO)
(909) 338-1875
Entity
Organization
Contact information
Practice address
580 FOREST SHADE RD, STE 7, CRESTLINE, CA 92325-9274
(909) 338-1875
(909) 338-1876
Mailing address
580 FOREST SHADE RD PO BOX 2220, STE 7, CRESTLINE, CA 92325-2220
(909) 338-1875
(909) 338-1876
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154295
PK
—
Enumeration date
03/15/2007
Last updated
09/30/2024
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