Organization
IMGRX HEALSDBURG INC
Active
Parent organization
IMGRX HEALSDBURG INC
Other names
AMC Community Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
IMGRX HEALSDBURG INC
Authorized official
MR. MICHAEL BROWN (VICE PRESIDENT, MANAGED SERVICES)
(281) 749-4764
Entity
Organization
Contact information
Practice address
1381 UNIVERSITY ST STE A, HEALDSBURG, CA 95448-3314
(707) 385-2336
(707) 431-8331
Mailing address
ATTN: CHC PHARMACY DEPT., 13651 DUBLIN CT., STAFFORD, TX 77477-4317
(281) 749-4000
(614) 652-0326
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
52502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152667
PK
—
Enumeration date
10/01/2014
Last updated
09/06/2022
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