Organization
ADVANTAGE HEALTH CARE HIV & COMPOUNDING INC
Active
Other names
GARDEN GROVE COMMUNITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAJNIS JASANI B.S.PHARMACY (SECRETARY)
(909) 948-8377
Entity
Organization
Contact information
Practice address
12665 GARDEN GROVE BLVD, SUITE 108, GARDEN GROVE, CA 92843-1901
(714) 530-1130
(714) 537-7736
Mailing address
12665 GARDEN GROVE BLVD, SUITE 108, GARDEN GROVE, CA 92843-1901
(714) 530-1130
(714) 537-7736
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
51109
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0521383
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/22/2006
Last updated
12/11/2012
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