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Contact Information

IMGRX SONOMA INC
19270 SONOMA HWY, SUITE A
SONOMA, CA95476
 Phone: 512-596-2930
 Fax: 707-939-6056
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for IMGRX SONOMA INC

NPI # 1952759664
LBN Legal business name IMGRX SONOMA INC
Authorized official MICHAEL BROWN - (VICE PRESIDENT, MANAGED SERVICES)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/03/2016
Last updated 09/15/2022 - About 4 years ago
Identifiers
CA License # PHY54507
Other 2163676 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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