Provider Demographics
NPI:1891392387
Name:ALTO PHARMACY, LLC
Entity Type:Organization
Organization Name:ALTO PHARMACY, LLC
Other - Org Name:ALTO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. MANAGER OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-874-5881
Mailing Address - Street 1:645 HARRISON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3624
Mailing Address - Country:US
Mailing Address - Phone:800-847-5881
Mailing Address - Fax:
Practice Address - Street 1:475 STATE HIGHWAY 121 BYP STE 150
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8154
Practice Address - Country:US
Practice Address - Phone:800-874-5881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTO PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-07
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5932656OtherNCPDP
TX33448OtherPHARMACY