Brookvale Medical Center Pharmacy
Organization Active NPI Pharmacist · San Pablo, CA
NPI 1124033519 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1124033519
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- PHY22575 (CA)
- Legal business name
- BROOKVALE MEDICAL CENTER PHARMACY
- Practice address
- 2101 Vale Rd
Ste 100
San Pablo, CA 94806 - Phone
- (510) 235-4443
- Fax
- (510) 235-5527
- NPI assigned
- Jul 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cathy Thompson
- Title
- Manager
- Phone
- (510) 235-4441
National Provider Directory
Locations
2101 Vale Rd
Ste 100
San Pablo, CA 94806
Phone (510) 235-4443
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | PHY22575 | CA | Yes |
Addresses
Primary practice location
2101 Vale Rd
Ste 100
San Pablo, CA 94806
Mailing address
2101 Vale Rd
Ste 100
San Pablo, CA 94806
Phone (510) 235-4443
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA225750 | Medicaid | CA |
Other names
- Park Pharmacy Inc
Other providers in San Pablo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.