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Organization

CEUTICARE LLC

Active
Other names
Regal Specialty Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
SHIRLEY PHAM (OWNER/PHARMACY MANAGER)
(951) 817-1005
Entity
Organization

Contact information

Practice address
1875 CALIFORNIA AVE STE 101, CORONA, CA 92881-6477
(951) 817-1005
Mailing address
1875 CALIFORNIA AVE STE 101, CORONA, CA 92881-6477
(951) 817-1005

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
57876
CALIFORNIA BOARD OF PHARMACY
CA
Enumeration date
01/19/2022
Last updated
01/19/2022
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