Organization
CEUTICARE LLC
Active
Other names
Regal Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY PHAM RPH (OWNER/PHARMACY MANAGER)
(951) 817-1005
Entity
Organization
Contact information
Practice address
1875 CALIFORNIA AVE STE 101, CORONA, CA 92881-6477
(951) 817-1005
(951) 817-1020
Mailing address
1875 CALIFORNIA AVE STE 101, CORONA, CA 92881-6477
(951) 817-1005
(951) 817-1020
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
55935
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57876
CALIFORNIA BOARD OF PHARMACY
CA
Enumeration date
01/12/2018
Last updated
10/29/2021
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