WADE J DAHLBERG SR


Address: 2697 Lavery Ct Ste 7, Newbury Park, CA 91320-1587
Phone: 8054990100

WADE J DAHLBERG SR (NPI# 1649576364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649576364
Entity Type Organization
Organization Name WADE J DAHLBERG SR
Other Organization Name WEST COAST PHARMACEUTICAL SERVICES
Practice Address 2697 Lavery Ct Ste 7
Newbury Park
CA 91320-1587
Practice Telephone 8054990100
Practice Fax Number 8054990199
Mailing Telephone 8054990100
Mailing Fax Number 8054990199
Enumeration Date 2011-01-27
Last Update Date 2011-02-07
Authorized Official Name WILLIAM DAHLBERG (OPERATION MGT)
Authorized Official Telephone 7023739215
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 3336I0012X Pharmacy
Specialization: Institutional Pharmacy
Suppliers
Y 3336L0003X Pharmacy
Specialization: Long Term Care Pharmacy
PHY50393 CA Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 5640087 01

Other Provider/Organization Names

Other Name Type Code
West Coast Pharmaceutical Services Doing Business As Name - Organization

Office Location

Street Address 2697 LAVERY CT STE 7
City NEWBURY PARK
State CA
Zip Code 91320-1587

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Taxonomy Information

Taxonomy Code 3336L0003X
Grouping Suppliers
Classification Pharmacy
Specialization Long Term Care Pharmacy

Taxonomy Definition

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

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Competitor

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City NEWBURY PARK
Zip Code 91320

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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