Organization
2500 MILVIA PRESCRIPTION PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN QUON CPHT (MANAGER)
(510) 548-0773
Entity
Organization
Contact information
Practice address
2500 MILVIA ST, STE 130, BERKELEY, CA 94704-2636
(510) 548-0773
(510) 548-6980
Mailing address
2500 MILVIA ST, STE 130, BERKELEY, CA 94704-2636
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY22894
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0569775
OTHER ID NUMBER
—
05
—
PHA228940
—
CA
Enumeration date
08/05/2006
Last updated
08/31/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us