Organization
BOTROSONS PHARMACEUTICAL INC
Active
Other names
LARSON'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ED BOTROS BACHELOR DEGREE (PIC)
(909) 825-1950
Entity
Organization
Contact information
Practice address
142 W H ST, COLTON, CA 92324-2923
(909) 825-1950
(909) 825-9330
Mailing address
142 W H ST, COLTON, CA 92324-2923
(909) 825-1950
(909) 825-9330
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1996200
PK
—
05
—
PHA174020
—
CA
05
—
PHA470350
—
CA
Enumeration date
10/12/2006
Last updated
02/16/2017
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