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NPI Code Detail

MEDICARE: CENTRAL COMMUNITY PHARMACY, INC.

MEDICARE: CENTRAL COMMUNITY PHARMACY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyPHY 47177CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952457418
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL COMMUNITY PHARMACY, INC.
Provider Business Mailing Address
First Line : 2701 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-5527
Country : US
Telephone Number : 323-846-1800
Fax Number : 323-846-1866
Provider Business Practice Location Address
First Line : 2701 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-5527
Country : US
Telephone Number : 323-846-1800
Fax Number : 323-846-1866
Authorized Official
Title or Position : CEO, PHARMACIST IN CHARGE, OWNER
Name : MR. OSAMA (SAM) M. SHOKAIR
Credential : R.PH.
Telephone Number : 323-846-1800
Provider Enumeration Date : 01/26/2007
Last Update Date : 08/22/2020

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Directions to “CENTRAL COMMUNITY PHARMACY, INC. ” Practice Location

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