Organization
ASR HEALTH INC.
Active
Other names
Queens Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVASA RAO KANDRU (DIRECTOR)
(760) 962-1200
Entity
Organization
Contact information
Practice address
12677 HESPERIA ROAD, SUITE 180, VICTORVILLE, CA 92395
(760) 962-1200
(760) 962-1222
Mailing address
12677 HESPERIA RD STE 180, VICTORVILLE, CA 92395-7754
(760) 962-1200
(760) 962-1222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHY57281
—
CA
Enumeration date
11/21/2005
Last updated
10/27/2020
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