Provider Demographics
NPI:1831381904
Name:GUIDED ALLIANCE PHARMACY INC
Entity type:Organization
Organization Name:GUIDED ALLIANCE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-496-3906
Mailing Address - Street 1:34145 PACIFIC COAST HWY
Mailing Address - Street 2:STE 195
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2808
Mailing Address - Country:US
Mailing Address - Phone:949-496-3906
Mailing Address - Fax:866-210-9757
Practice Address - Street 1:27111 ALISO CREEK RD
Practice Address - Street 2:STE 185A
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3365
Practice Address - Country:US
Practice Address - Phone:949-496-4106
Practice Address - Fax:866-210-9757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X
CA534253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2113087OtherPK