Type | Company | [sources] | |||
---|---|---|---|---|---|
Name | Bacon East Pharmacy I | [sources] | |||
Incorporation date | not available | [sources] | |||
Jurisdiction | not available | [sources] | |||
Country | United States | [sources] | |||
NPI | 1295746873 | [sources] | |||
Registration number | PHA330760 · PHY 33076 · PHY 50632 · PHY 53596 · ZZZ30023Z | [sources] | |||
Sector | Entity/Corporation | [sources] | |||
Address | 2425 East Street, Suite 5, Concord, CA, 94520 | [sources] | |||
Last change | Last processed | First seen |
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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