Provider Demographics
NPI:1124872916
Name:UNIK CARE PHARMCY
Entity type:Organization
Organization Name:UNIK CARE PHARMCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:UNIMKE
Authorized Official - Last Name:UNDIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:404-849-2014
Mailing Address - Street 1:6855 PORTOFINO CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-8637
Mailing Address - Country:US
Mailing Address - Phone:404-849-2014
Mailing Address - Fax:909-363-8796
Practice Address - Street 1:4297M N SIERRA WAY
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-3820
Practice Address - Country:US
Practice Address - Phone:404-849-2014
Practice Address - Fax:909-363-8796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy