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DESERT AGAVE PHARMACY INC NPI 1407122815


NPI Information

NPI: 1407122815
Provider Name: DESERT AGAVE PHARMACY INC

Doing Business As: DE ANZA PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
302 #B E 3RD ST
CALEXICO, CA
ZIP 92231
Phone: (760) 768-2900
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DESERT AGAVE PHARMACY INC is a community/retail pharmacy pharmacy in Calexico, 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. DESERT AGAVE PHARMACY INC NPI is 1407122815. The provider is registered as an organization entity type.
The provider Is Doing Business As De Anza Pharmacy.

The provider's business location address is:

302 #B E 3RD ST
CALEXICO, CA
ZIP 92231-760
Phone: (760) 768-2900
Fax: (760) 768-2929

The provider's authorized official is Gregory Gelman .
The authorized official title is President/pic and has the following contact phone number (760) 768-2900.

The enumeration date for this NPI number is 3/29/2012 and was last updated on 3/7/2023.


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
1333600000XPharmacyPHY50893CALIFORNIANo
23336C0003XPharmacyCommunity/Retail PharmacyPHY50893CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHY50893OTHERCALIFORNIACALIFORNIA STATE BOARD OF PHARMACY

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: 4/28/2024

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