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Organization

ASCENCION INC

Active
Other names
LOS OSOS REXALL DRUG STORE
Organization subpart
No

Provider details

NPI number
Authorized official
GARY TEWELL (PRESIDENT)
(805) 528-1017
Entity
Organization

Contact information

Practice address
989 LOS OSOS VALLEY RD, LOS OSOS, CA 93402-3205
(805) 528-1017
(805) 528-1915
Mailing address
989 LOS OSOS VALLEY RD, LOS OSOS, CA 93402-3205
(805) 528-1017
(805) 528-1915

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHY22201
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2115987
PK
05
PHA206500
CA
Enumeration date
08/31/2006
Last updated
06/28/2016
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