Organization
EGYPTIAN INC
Active
Other names
TruCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MINA KOLTA (RPH OWNER)
(951) 817-1005
Entity
Organization
Contact information
Practice address
1875 CALIFORNIA AVE, CORONA, CA 92881-6477
(951) 817-1005
(951) 817-1020
Mailing address
1875 CALIFORNIA AVE, CORONA, CA 92881-6477
(951) 817-1005
(951) 817-1020
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHY51885
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147466
PK
—
Enumeration date
08/25/2014
Last updated
05/05/2015
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