Provider Demographics
NPI:1003527904
Name:OMEGURU PHARMACY INC
Entity Type:Organization
Organization Name:OMEGURU PHARMACY INC
Other - Org Name:BEST WEST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADHU
Authorized Official - Middle Name:
Authorized Official - Last Name:VANGA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:209-255-2035
Mailing Address - Street 1:400 W I ST STE D
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-3459
Mailing Address - Country:US
Mailing Address - Phone:209-255-2305
Mailing Address - Fax:209-310-9659
Practice Address - Street 1:400 W I ST STE D
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-3459
Practice Address - Country:US
Practice Address - Phone:209-255-2305
Practice Address - Fax:209-310-9659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy