Organization
RIDGECREST REGIONAL HOSPITAL
Active
Organization
RIDGECREST REGIONAL HOSPITAL
Active
Other names
Center Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH FURTADO PHARM.D. (PHARMACIST IN CHARGE)
(760) 446-4141
Entity
Organization
Contact information
Practice address
1109 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3131
(760) 446-4141
(760) 446-4600
Mailing address
1109 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3131
(760) 446-4141
(760) 446-4600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
53935
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790811289
—
CA
01
—
2162070
PK
—
Enumeration date
02/26/2007
Last updated
01/10/2020
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