Organization
SKY PHARMA CORP
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TADROS RPH (PHARMACIST IN CHARGE /CEO)
(951) 509-9277
Entity
Organization
Contact information
Practice address
10237 MAGNOLIA AVE, RIVERSIDE, CA 92503-3440
(951) 509-9277
(951) 509-9288
Mailing address
10237 MAGNOLIA AVE, RIVERSIDE, CA 92503-3440
(951) 509-9277
(951) 509-9288
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
51646
CA
3336C0004X
Compounding Pharmacy
51646
CA
3336H0001X
Home Infusion Therapy Pharmacy
99865
CA
3336S0011X
Specialty Pharmacy
51646
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA51646
—
CA
Enumeration date
10/23/2013
Last updated
12/07/2016
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