Organization
BRAND NEW PHARMACY INC
Active
Other names
Brand New Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMS H GERGES OWNER (OWNER,MGR,AO)
(909) 335-5400
Entity
Organization
Contact information
Practice address
1819 W REDLANDS BLVD STE 101, REDLANDS, CA 92373-3121
(909) 335-5400
(909) 335-9300
Mailing address
1819 W REDLANDS BLVD STE 101, REDLANDS, CA 92373-3121
(909) 335-5400
(909) 335-9300
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52439
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150391
PK
—
05
—
PHA52439
—
CA
Enumeration date
02/14/2015
Last updated
03/04/2021
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