Organization
BEST PHARMACY GROUP INC
Active
Other names
Mirage Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PRASAD REDDY (PRESIDENT)
(909) 793-8205
Entity
Organization
Contact information
Practice address
35400 BOB HOPE DR, SUITE 207, RANCHO MIRAGE, CA 92270-1772
(760) 328-2115
(760) 202-1333
Mailing address
511 AMIGOS DR STE A, REDLANDS, CA 92373-6283
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
49961
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5634527
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/15/2009
Last updated
12/20/2010
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