Provider Demographics
NPI:1194855304
Name:ACE HEALTH SOLUTIONS INC
Entity Type:Organization
Organization Name:ACE HEALTH SOLUTIONS INC
Other - Org Name:ACE RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAVATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-778-5444
Mailing Address - Street 1:1861 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2912
Mailing Address - Country:US
Mailing Address - Phone:805-778-5444
Mailing Address - Fax:805-778-5444
Practice Address - Street 1:1861 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2912
Practice Address - Country:US
Practice Address - Phone:805-778-5444
Practice Address - Fax:805-778-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336S0011X
CA555103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92354-03Medicaid