Provider Demographics
NPI:1780856914
Name:PALMIERI PHARMACY INC
Entity Type:Organization
Organization Name:PALMIERI PHARMACY INC
Other - Org Name:PALMIERI PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-737-3511
Mailing Address - Street 1:800 MAGNOLIA AVE
Mailing Address - Street 2:STE 116
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3123
Mailing Address - Country:US
Mailing Address - Phone:951-737-3511
Mailing Address - Fax:951-737-2148
Practice Address - Street 1:800 MAGNOLIA AVE
Practice Address - Street 2:STE 116
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3123
Practice Address - Country:US
Practice Address - Phone:951-737-3511
Practice Address - Fax:951-737-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY-519513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149691OtherPK
CA1902900277OtherNPI TYPE 1
CA0553506OtherNABP
CA4546870001Medicare NSC