Organization
CCF&K LIMITED LIABILITY COMPANY
Active
Organization
CCF&K LIMITED LIABILITY COMPANY
Active
Other names
Community Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CLEMENT AJAYI (OWNER)
(760) 242-2559
Entity
Organization
Contact information
Practice address
16070 TUSCOLA RD STE 102, APPLE VALLEY, CA 92307-1691
(760) 242-2559
(760) 242-8070
Mailing address
16070 TUSCOLA RD STE 102, SUITE #102, APPLE VALLEY, CA 92307-1691
(760) 242-2559
(760) 242-8070
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51876
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146438
PK
—
Enumeration date
02/02/2007
Last updated
05/01/2017
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