Healthcare Provider Details
I. General information
NPI: 1184635773
Provider Name (Legal Business Name): MORCO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3440 LOMITA BLVD STE 149
TORRANCE CA
90505-4801
US
IV. Provider business mailing address
PO BOX 13237
TORRANCE CA
90503-0237
US
V. Phone/Fax
- Phone: 310-326-7706
- Fax: 310-326-8568
- Phone: 310-326-7706
- Fax: 310-326-8568
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 | PHY42192 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARJAN
AMINI
Title or Position: RPH
Credential: RPH
Phone: 310-326-7706