Provider Demographics
NPI:1154914190
Name:C&S PHARMACY
Entity type:Organization
Organization Name:C&S PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARISPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-362-2019
Mailing Address - Street 1:49281 GRAPEFRUIT BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1486
Mailing Address - Country:US
Mailing Address - Phone:760-296-3468
Mailing Address - Fax:760-296-3438
Practice Address - Street 1:49281 GRAPEFRUIT BLVD STE 2
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1486
Practice Address - Country:US
Practice Address - Phone:760-296-3468
Practice Address - Fax:760-296-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty