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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Bacon East Pharmacy I · Bacon East Pharmacy II | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| NPI | 1295746873 | [sources] | |||
| Registration number | PHA330760 · PHY 33076 · PHY 50632 · PHY 53596 · PHY 57144 · | [sources] | |||
| Sector | Entity/Corporation | [sources] | |||
| Address | 2425 East Street, No. 114 and 116, Concord, CA, 94520 · 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 of America · DHCS
us-medca-947c5ac1d5b424d1fefe10120b1da723e47e8cbf · us-medca-a5c7ae4ffb4fc2b636daaddad0a49fc10cc2968dFor experts: raw data explorer
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| United States of America | Department of Health Care Services | - | - |