Organization
COUNTY OF SAN DIEGO
Active
Other names
EDGEMOOR HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GWENMARIE HILLEARY (ADMINISTRATOR)
(619) 596-5500
Entity
Organization
Contact information
Practice address
655 PARK CENTER DR, SANTEE, CA 92071-6957
(619) 596-6340
(619) 596-6341
Mailing address
655 PARK CENTER DR, SANTEE, CA 92071-6957
(619) 596-6340
(619) 596-6341
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
34002
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114082
PK
—
05
—
ZZT05008F
—
CA
Enumeration date
07/30/2006
Last updated
11/12/2015
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