Organization
FOUNTAIN VALLEY CENTRAL PHARMACY INC
Active
Organization
FOUNTAIN VALLEY CENTRAL PHARMACY INC
Active
Other names
FOUNTAIN VALLEY CENTRAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LE (OWNER)
(714) 839-5115
Entity
Organization
Contact information
Practice address
11055 WARNER AVE, FOUNTAIN VALLEY, CA 92708-4007
(714) 839-5115
(714) 839-4656
Mailing address
11055 WARNER AVE, FOUNTAIN VALLEY, CA 92708-4007
(714) 839-5115
(714) 839-4656
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY40236
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2116214
PK
—
05
—
PHA402360
—
CA
Enumeration date
08/10/2006
Last updated
12/05/2016
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