Organization
SPECIALTY PHARMA SAI INC
Active
Organization
SPECIALTY PHARMA SAI INC
Active
Other names
Mkt Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAYA LAXMI (PRESIDENT)
(949) 590-0056
Entity
Organization
Contact information
Practice address
4153B UNIVERSITY AVE, SUITE B, SAN DIEGO, CA 92105-1421
(949) 590-0056
(619) 333-2525
Mailing address
15642 SAND CANYON AVE UNIT 53871, IRVINE, CA 92619-5430
(949) 590-0056
(619) 333-2525
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386226306
—
CA
01
—
5674812
NCPDP
—
01
—
PHY58096
CALIFORNIA BOARD OF PHARMACY
CA
Enumeration date
04/28/2021
Last updated
04/29/2022
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