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Organization

PACIFIC PHARMACY GROUP

Active
Other names
Fallbrook LTC Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JAN BALTHASAR (CEO)
(949) 215-5522
Entity
Organization

Contact information

Practice address
343 E ALVARADO ST, SUITE C, FALLBROOK, CA 92028-2966
(760) 728-6142
(760) 728-6382
Mailing address
343 E ALVARADO ST, SUITE C, FALLBROOK, CA 92028-2966
(760) 728-6142
(760) 728-6382

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
51247
CA
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2140772
PK
Enumeration date
05/31/2013
Last updated
06/14/2013
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