Organization
AMIS PHARMACY CORPORATION
Active
Other names
Mecca Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON HUYNH (PRESIDENT/PIC)
(760) 684-2337
Entity
Organization
Contact information
Practice address
91275 AVENUE 66, SUITE 200, MECCA, CA 92254
(760) 396-3000
(760) 396-9479
Mailing address
PO BOX 968, ATWOOD, CA 92811-0968
(714) 798-5808
(760) 269-3142
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831348515
—
CA
01
—
2116875
PK
—
Enumeration date
09/17/2008
Last updated
05/01/2013
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