Provider Demographics
NPI:1356525760
Name:OPTIMAL PHARMACIES INC
Entity type:Organization
Organization Name:OPTIMAL PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:LEROY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:661-716-2673
Mailing Address - Street 1:2110 TRUXTUN AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3703
Mailing Address - Country:US
Mailing Address - Phone:661-716-2673
Mailing Address - Fax:661-716-2677
Practice Address - Street 1:2110 TRUXTUN AVE
Practice Address - Street 2:STE 300
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3703
Practice Address - Country:US
Practice Address - Phone:661-716-2673
Practice Address - Fax:661-716-2677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KOMOTO PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-20
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY460423336C0003X, 3336C0004X
CALSC990713336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy