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General NPI Number Information
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NPI Number | 1265546238
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Entity Type | Organization
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Legal Business Name | J P MARCO INC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 4762 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-3026
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Country | US
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Telephone | 323-269-7958
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Fax | 323-269-1312
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Provider Business Mailing Address
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Address Line | 4762 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-3026
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Country | US
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Telephone | 323-269-7958
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Fax | 323-269-1312
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Authorized Official
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Title or Position | PIC
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Name | JOSE MARCO
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Credential | RPH
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Telephone | 323-269-7958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY36756
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License Number State | CA
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