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General NPI Number Information
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NPI Number | 1386655934
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Entity Type | Organization
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Legal Business Name | FMC PHARMACY INC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 1676 HOSPITAL DR
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City | SANTA FE
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State | NM
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Zip | 87505-4754
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Country | US
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Telephone | 505-983-4359
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Fax | 505-983-5259
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Provider Business Mailing Address
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Address Line | 560 N BEVERLY GLEN BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90077-3504
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Country | US
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Telephone | 310-556-4422
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Fax | 310-276-9414
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Authorized Official
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Title or Position | PHARMACY EXECUTIVE
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Name | TERRY CATER
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Credential | RPH
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Telephone | 925-895-1506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH00003035
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License Number State | NM
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