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TUSTIN COMMUNITY PHARMACY INC NPI 1497891766


NPI Information

NPI: 1497891766
Provider Name: TUSTIN COMMUNITY PHARMACY INC

Doing Business As: VILLA PARK PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 05D2155695

Address:
17821 SANTIAGO BLVD
VILLA PARK, CA
ZIP 92861
Phone: (714) 998-3030
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TUSTIN COMMUNITY PHARMACY INC is a community/retail pharmacy pharmacy in Villa Park, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. TUSTIN COMMUNITY PHARMACY INC NPI is 1497891766. The provider is registered as an organization entity type.
The provider Is Doing Business As Villa Park Pharmacy.

The provider's business location address is:

17821 SANTIAGO BLVD
VILLA PARK, CA
ZIP 92861-133
Phone: (714) 998-3030
Fax: (714) 998-6060

The provider's authorized official is Adam Bollenbach .
The authorized official title is Pharmacist-in-charge, Vice Pres. and has the following contact phone number (714) 998-3030.

The CLIA number assigned to this NPI record is 05D2155695 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyPHY46551CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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