Provider Demographics
NPI:1649427139
Name:FAST PHARMACY INC.
Entity type:Organization
Organization Name:FAST PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-698-9229
Mailing Address - Street 1:PO BOX 1790
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92593-1790
Mailing Address - Country:US
Mailing Address - Phone:951-698-9229
Mailing Address - Fax:951-698-9229
Practice Address - Street 1:1820 FULLERTON AVE
Practice Address - Street 2:SUITE 145
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3160
Practice Address - Country:US
Practice Address - Phone:877-327-8009
Practice Address - Fax:877-327-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPPLYING FOR3336C0003X, 3336M0002X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy