Organization
ALEXANDER IRVINE
Active
Organization
ALEXANDER IRVINE
Active
Other names
GUADALUPE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX IRVINE (OWNER)
(805) 343-2290
Entity
Organization
Contact information
Practice address
4581 10TH ST, STE A, GUADALUPE, CA 93434-1454
(805) 343-2290
(805) 343-0761
Mailing address
PO BOX 697, GUADALUPE, CA 93434-0697
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY21220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533489
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA21220
—
CA
Enumeration date
12/26/2006
Last updated
03/20/2012
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