Organization
CALIFORNIA STATE UNIVERSITY FULLERTON
Active
Other names
STUDENT HEALTH AND COUNSELING CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY J SPOTFORD MBA (DIRECTOR)
(657) 278-2822
Entity
Organization
Contact information
Practice address
800 N STATE COLLEGE BLVD, FULLERTON, CA 92831-3547
(714) 278-2890
(714) 278-5508
Mailing address
PO BOX 6830, FULLERTON, CA 92834-6830
(714) 278-2890
(714) 278-5508
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHE19591
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0573382
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA195910
—
CA
Enumeration date
07/30/2006
Last updated
08/28/2013
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