Organization
PAIN MANAGEMENT PHARMACY INC
Active
Other names
PAIN MANAGEMENT PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH GUESS PHARMD (CEO VP)
(805) 928-4700
Entity
Organization
Contact information
Practice address
2003 S MILLER ST, SANTA MARIA, CA 93454-7849
(805) 928-4700
(805) 928-4710
Mailing address
2003 S MILLER ST, SANTA MARIA, CA 93454-7849
(805) 928-4700
(805) 928-4710
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46656
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5612848
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA466560
—
CA
Enumeration date
07/20/2006
Last updated
01/31/2013
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