Provider Demographics
NPI:1679866057
Name:PNR PHARMA INC.
Entity Type:Organization
Organization Name:PNR PHARMA INC.
Other - Org Name:CALIFORNIA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-775-2000
Mailing Address - Street 1:14541 BROOKHURST ST STE C5
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5784
Mailing Address - Country:US
Mailing Address - Phone:714-775-2000
Mailing Address - Fax:714-775-2002
Practice Address - Street 1:14541 BROOKHURST ST STE C5
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5784
Practice Address - Country:US
Practice Address - Phone:714-775-2000
Practice Address - Fax:714-775-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50647333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6564490001Medicare NSC