Organization
PHARMEDQUEST PHARMACY SERVICES
Active
Other names
Avita Pharmacy 1025
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTEN GURLEY (VP LEGAL AFFAIRS)
(469) 592-2011
Entity
Organization
Contact information
Practice address
3020 SATURN ST STE 100, BREA, CA 92821-6262
(877) 362-9778
(714) 364-1448
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
(714) 599-8181
(714) 599-8242
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
55894
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568963312
—
CA
01
—
2176010
PK
—
Enumeration date
02/27/2018
Last updated
06/14/2024
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