Provider Demographics
NPI:1326158528
Name:BONES MANAGEMENT, INC.
Entity Type:Organization
Organization Name:BONES MANAGEMENT, INC.
Other - Org Name:SIERRA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-407-9338
Mailing Address - Street 1:14241 FIRESTONE BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5530
Mailing Address - Country:US
Mailing Address - Phone:562-407-9338
Mailing Address - Fax:562-407-9340
Practice Address - Street 1:210 S GRAND AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4205
Practice Address - Country:US
Practice Address - Phone:626-335-2300
Practice Address - Fax:626-914-0713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY347193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0533326OtherNCPDP
CAPHD139050Medicaid
CA1230220001Medicare NSC