Healthcare Provider Details
I. General information
NPI: 1891123527
Provider Name (Legal Business Name): THE MEDICINE CABINET INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2013
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3270 TWEEDY BLVD STE C
SOUTH GATE CA
90280-4372
US
IV. Provider business mailing address
9901 PARAMOUNT BLVD STE 110
DOWNEY CA
90240-3843
US
V. Phone/Fax
- Phone: 323-564-2056
- Fax:
- Phone: 562-806-8394
- Fax: 562-776-2257
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 | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHY51642 |
| License Number State | CA |
VIII. Authorized Official
Name:
ASH
SOLIMAN
Title or Position: PRESIDENT
Credential:
Phone: 562-806-8394