Organization
LTC PHARMACY VENTURES CORP
Active
Other names
STAR LTC PHARMACY SD
Organization subpart
No
Provider details
NPI number
Authorized official
YEFIM ISKHAKOV (PRESIDENT/CEO)
(858) 878-4150
Entity
Organization
Contact information
Practice address
161 E MAIN ST STE 104, EL CAJON, CA 92020-3993
(858) 878-4150
(858) 878-4152
Mailing address
161 E MAIN ST STE 104, EL CAJON, CA 92020-3993
(858) 878-4150
(858) 878-4152
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY60529
BOARD OF PHARMACY
CA
Enumeration date
08/24/2023
Last updated
02/03/2025
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