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Organization

C&A MEDICAL 1

Active
Other names
Advanced Care Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MARYAM SHARAFSALEH (PRESIDENT)
(760) 212-2761
Entity
Organization

Contact information

Practice address
22642 LAMBERT ST STE 404, LAKE FOREST, CA 92630-1645
(949) 347-8881
(949) 347-8886
Mailing address
22642 LAMBERT ST, SUITE 404, LAKE FOREST, CA 92630-1610
(949) 347-8881
(949) 347-8886

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
49911
CA
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2122438
PK
Enumeration date
10/16/2009
Last updated
11/06/2013
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