Provider Demographics
NPI:1457362949
Name:CWL PHARMACIES INC
Entity Type:Organization
Organization Name:CWL PHARMACIES INC
Other - Org Name:COMMUNITY PHCY OF ESCONDIDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-743-6300
Mailing Address - Street 1:29115 VALLEY CENTER RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-6553
Mailing Address - Country:US
Mailing Address - Phone:760-749-1156
Mailing Address - Fax:760-749-1921
Practice Address - Street 1:757 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3009
Practice Address - Country:US
Practice Address - Phone:760-743-6300
Practice Address - Fax:760-743-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
CAPHY394163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA394160Medicaid
0580971OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CAPHA394160Medicaid