Provider Demographics
NPI:1952608812
Name:GUIDED ALLIANCE PHARMACY INC
Entity type:Organization
Organization Name:GUIDED ALLIANCE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-496-3906
Mailing Address - Street 1:7025 LONGLEY LN
Mailing Address - Street 2:SUITE 30-A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1238
Mailing Address - Country:US
Mailing Address - Phone:775-853-4273
Mailing Address - Fax:775-853-7694
Practice Address - Street 1:7025 LONGLEY LN
Practice Address - Street 2:SUITE 30-A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1238
Practice Address - Country:US
Practice Address - Phone:775-853-4273
Practice Address - Fax:775-853-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH026853336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2992560OtherNCPDP PROVIDER IDENTIFICATION NUMBER