Provider Demographics
NPI:1851304570
Name:A & R PHARMACY INC
Entity Type:Organization
Organization Name:A & R PHARMACY INC
Other - Org Name:MOULTON PLAZA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:HASOLKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-768-3784
Mailing Address - Street 1:23665 MOULTON PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1937
Mailing Address - Country:US
Mailing Address - Phone:949-768-3784
Mailing Address - Fax:949-768-1359
Practice Address - Street 1:23665 MOULTON PKWY
Practice Address - Street 2:STE A
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1937
Practice Address - Country:US
Practice Address - Phone:949-768-3784
Practice Address - Fax:949-768-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
CAPHY474883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1998352OtherPK
5759740001Medicare NSC