Organization
J & S BIRDSONG PHARMACY INC
Active
Organization
J & S BIRDSONG PHARMACY INC
Active
Other names
CENTRAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL BIRDSONG RPH (OWNER)
(760) 352-0600
Entity
Organization
Contact information
Practice address
600 W MAIN ST, EL CENTRO, CA 92243-2920
(760) 352-0600
(760) 352-0220
Mailing address
600 W MAIN ST, EL CENTRO, CA 92243-2920
(760) 352-0600
(760) 352-0220
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY43713
CA
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1990207
PK
—
05
—
PHA437130
—
CA
Enumeration date
06/20/2005
Last updated
08/08/2013
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