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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