Organization
POKEY BONES LLC
Active
Other names
FAAST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA FAAST PHARMD (OWNER)
(661) 410-7979
Entity
Organization
Contact information
Practice address
3400 CALLOWAY DR, STE 701, BAKERSFIELD, CA 93312-2513
(661) 410-7979
(661) 410-7980
Mailing address
3400 CALLOWAY DR, STE 701, BAKERSFIELD, CA 93312-2513
(661) 410-7979
(661) 410-7980
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47454
CA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5618181
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHY474540
—
CA
Enumeration date
06/02/2006
Last updated
08/29/2011
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