Provider Demographics
NPI:1295836336
Name:VISTA PHARMACIES, INC.
Entity Type:Organization
Organization Name:VISTA PHARMACIES, INC.
Other - Org Name:PICO VISTA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:DARSHAN
Authorized Official - Middle Name:SATISH
Authorized Official - Last Name:BHAKTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:562-908-7012
Mailing Address - Street 1:9201 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-2450
Mailing Address - Country:US
Mailing Address - Phone:562-908-7012
Mailing Address - Fax:562-908-7014
Practice Address - Street 1:9201 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2450
Practice Address - Country:US
Practice Address - Phone:562-908-7012
Practice Address - Fax:562-908-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY462043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5600019OtherNCPDP
CAPHA462040Medicaid