Provider Demographics
NPI:1679930069
Name:ONYX PHARMACY SOLUTIONS LLC
Entity Type:Organization
Organization Name:ONYX PHARMACY SOLUTIONS LLC
Other - Org Name:BLUE COAST PHARMACY AND COMPOUNDING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-465-9334
Mailing Address - Street 1:18700 MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1713
Mailing Address - Country:US
Mailing Address - Phone:714-465-9334
Mailing Address - Fax:714-465-9039
Practice Address - Street 1:18700 MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1713
Practice Address - Country:US
Practice Address - Phone:714-465-9334
Practice Address - Fax:714-465-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CA537863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157654OtherPK