Organization
COUNTRY VILLAGE PHARMACY
Active
Organization
COUNTRY VILLAGE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD ARSHAD PHARMACIST (OWNER)
(951) 681-8889
Entity
Organization
Contact information
Practice address
10251 COUNTRY CLUB DR, STE B, MIRA LOMA, CA 91752-1329
(951) 681-8889
(951) 681-2948
Mailing address
10251 COUNTRY CLUB DR, STE B, MIRA LOMA, CA 91752-1329
(951) 681-8889
(951) 681-2948
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY34166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997702
PK
—
05
—
PHA341660
—
CA
Enumeration date
10/03/2006
Last updated
01/23/2018
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