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Bacon East Pharmacy I

Debarred entity
TypeCompany[sources]
NameBacon East Pharmacy I[sources]
Incorporation datenot available[sources]
Jurisdictionnot available[sources]
CountryUnited States[sources]
DescriptionLicense number(s): PHY 33076, PHY 50632, PHY 53596 · Provider number(s): ZZZ30023Z, PHA330760, 1295746873[sources]
Registration numbernot available[sources]
SectorEntity/Corporation[sources]
Address2425 East Street, Suite 5, Concord, CA, 94520[sources]
Last changeLast processedFirst seen

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Data sources

US California Medicaid Suspended and ineligible providers22,466

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States · DHCS


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