Provider Demographics
NPI:1023618824
Name:INGRAM'S PHARMACY, LLC
Entity type:Organization
Organization Name:INGRAM'S PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:661-342-1643
Mailing Address - Street 1:1115 UNION AVE UNIT 147-1C
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-1050
Mailing Address - Country:US
Mailing Address - Phone:661-342-1643
Mailing Address - Fax:
Practice Address - Street 1:1115 UNION AVE UNIT 147-1C
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-1050
Practice Address - Country:US
Practice Address - Phone:661-342-1643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INGRAM'S PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy