Provider Demographics
NPI:1922337575
Name:ALISAL PHARMACIES, INC
Entity Type:Organization
Organization Name:ALISAL PHARMACIES, INC
Other - Org Name:ALISAL LTC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BASRAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-797-2772
Mailing Address - Street 1:323 N SANBORN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2247
Mailing Address - Country:US
Mailing Address - Phone:831-759-8184
Mailing Address - Fax:831-424-0197
Practice Address - Street 1:323 N SANBORN RD STE A
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2243
Practice Address - Country:US
Practice Address - Phone:831-759-8184
Practice Address - Fax:831-759-9529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY56894OtherBOP
CA1922337575Medicaid