Provider Demographics
NPI:1376054411
Name:NEW LEAF PHARMACY INC
Entity Type:Organization
Organization Name:NEW LEAF PHARMACY INC
Other - Org Name:NEW LEAF PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:BASSEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSIHA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:626-502-3994
Mailing Address - Street 1:4433 MING AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4817
Mailing Address - Country:US
Mailing Address - Phone:661-885-9707
Mailing Address - Fax:661-885-9709
Practice Address - Street 1:4433 MING AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4817
Practice Address - Country:US
Practice Address - Phone:661-885-9707
Practice Address - Fax:661-885-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy