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General NPI Number Information
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NPI Number | 1164560033
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Entity Type | Organization
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Legal Business Name | HARTLEY MEDICAL CENTER PHARMACY INC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 113 W VICTORIA ST
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City | LONG BEACH
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State | CA
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Zip | 90805
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Country | US
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Telephone | 562-595-7548
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Fax | 562-595-9855
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Provider Business Mailing Address
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Address Line | 113 W VICTORIA ST
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City | LONG BEACH
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State | CA
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Zip | 90805
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Country | US
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Telephone | 562-595-7548
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Fax | 562-595-9855
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Authorized Official
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Title or Position | PRSIDENT
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Name | MR. WILLIAM A STUART
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Credential |
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Telephone | 562-595-7548
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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 | PHY20643
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH20643
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License Number State | CA
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