Healthcare Provider Details
I. General information
NPI: 1073250122
Provider Name (Legal Business Name): MARKET PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2022
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
174 S ALVARADO ST
LOS ANGELES CA
90057-2211
US
IV. Provider business mailing address
PO BOX 3055
HUNTINGTON BEACH CA
92605-3055
US
V. Phone/Fax
- Phone: 213-483-8741
- Fax: 213-483-8743
- Phone: 714-706-9030
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
ZEGLINSKI
Title or Position: CEO
Credential:
Phone: 714-706-9030