Organization
KOHANA PHARMACY AND CENTER FOR REGENERATIVE MEDICINE INC
Active
Other names
Kohana Pharmacy and Center for Regenerative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT QUINN PHARMD (PHARMACIST)
(805) 542-0864
Entity
Organization
Contact information
Practice address
181 TANK FARM RD STE 120, SAN LUIS OBISPO, CA 93401-7082
(805) 542-0864
(805) 542-0867
Mailing address
181 TANK FARM RD, SUITE 120, SAN LUIS OBISPO, CA 93401-7080
(805) 542-0864
(805) 542-0867
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50264
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124185
PK
—
Enumeration date
03/11/2010
Last updated
02/10/2015
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