Provider Demographics
NPI:1225636889
Name:MED-PLUS PHARMACY LLC
Entity Type:Organization
Organization Name:MED-PLUS PHARMACY LLC
Other - Org Name:POLARIS PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR OF COMPLIANCE, C
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-589-9747
Mailing Address - Street 1:277 E. ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3149
Mailing Address - Country:US
Mailing Address - Phone:866-463-3757
Mailing Address - Fax:626-593-5733
Practice Address - Street 1:335 LINDBERGH AVE
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-9291
Practice Address - Country:US
Practice Address - Phone:888-222-8405
Practice Address - Fax:877-363-3757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED-PLUS PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-15
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy