Organization
FULFILLING HEALTHCARE SERVICES LLC
Active
Organization
FULFILLING HEALTHCARE SERVICES LLC
Active
Other names
PARKVIEW PHARMACY AND HOME HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS PETRIE PHARM D (OWNER MANAGER)
(909) 981-0956
Entity
Organization
Contact information
Practice address
8283 GROVE AVE, STE 105, RANCHO CUCAMONGA, CA 91730-3137
(909) 981-0956
(909) 981-8409
Mailing address
PO BOX 572227, TARZANA, CA 91357-2227
(909) 981-0956
(909) 981-8409
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47210
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1990970
PK
—
05
—
PHA47210
—
CA
Enumeration date
07/24/2006
Last updated
09/13/2016
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