Provider Demographics
NPI:1306839824
Name:ALLIED PHARMACY SERVICES, LLC.
Entity Type:Organization
Organization Name:ALLIED PHARMACY SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASTROCOLA
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:714-241-5600
Mailing Address - Street 1:99 ESCUELA DR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4003
Mailing Address - Country:US
Mailing Address - Phone:650-994-6900
Mailing Address - Fax:650-994-6902
Practice Address - Street 1:99 ESCUELA DR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4003
Practice Address - Country:US
Practice Address - Phone:650-994-6900
Practice Address - Fax:650-994-6902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE GENERATIONS HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-30
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0557869OtherNABP
3842780001Medicare NSC