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General NPI Number Information
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NPI Number | 1124422860
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Entity Type | Organization
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Legal Business Name | MOLINA RX PHARMACY, INC
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 12101 WOODRUFF AVE SUITE C
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City | DOWNEY
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State | CA
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Zip | 90241-5628
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Country | US
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Telephone | 562-803-1312
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Fax | 562-803-4687
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Provider Business Mailing Address
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Address Line | 12101 WOODRUFF AVE SUITE C
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City | DOWNEY
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State | CA
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Zip | 90241-5628
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Country | US
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Telephone | 562-803-1312
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Fax | 562-803-4687
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALFREDO MOLINA
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Credential |
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Telephone | 562-716-2586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY53327
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License Number State | CA
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