Organization
ASSURED PHARMACY
Active
Other names
Assured Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER ROBLES (CONTRACTING ADMINISTRATOR)
(949) 222-9971
Entity
Organization
Contact information
Practice address
2040 PACIFIC COAST HWY, STE R, LOMITA, CA 90717-2660
(949) 222-9971
(949) 271-5580
Mailing address
17935 SKY PARK CIR, STE F, IRVINE, CA 92614-6321
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 48925
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5632698
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/10/2008
Last updated
11/10/2008
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