Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifetime Pharmacy Corp

Organization Durable Medical Equipment & Medical Supplies · NPI 1558512848

Lifetime Pharmacy Corp is a Durable Medical Equipment & Medical Supplies in Moreno Valley, California. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
3
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

23080 Alessandro Blvd Ste 212
Moreno Valley, CA 92553-9673
Phone: (951) 656-7171
Fax: (951) 656-6363
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1558512848
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ronald Vandyke — Ceo · (951) 656-7171
NPI enumeratedOctober 4, 2008
Last updated in NPPESMarch 10, 2020
Certification dateMarch 10, 2020
Mailing address23080 Alessandro Blvd, Ste 212, Moreno Valley, CA 92553-9673

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