Provider Demographics
NPI:1780866749
Name:ADVANTAGE PHARMACEUTICALS
Entity Type:Organization
Organization Name:ADVANTAGE PHARMACEUTICALS
Other - Org Name:ADVANTAGE PHARMACEUTICAL INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-630-4960
Mailing Address - Street 1:4351 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2117
Mailing Address - Country:US
Mailing Address - Phone:916-630-4960
Mailing Address - Fax:916-630-4969
Practice Address - Street 1:4351 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2117
Practice Address - Country:US
Practice Address - Phone:916-630-4960
Practice Address - Fax:916-630-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY469623336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2113402OtherPK