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General NPI Number Information
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NPI Number | 1467431791
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Entity Type | Organization
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Legal Business Name | SOUTH WESTERN PHARMACY
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 7301 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90047-2254
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Country | US
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Telephone | 323-752-1692
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Fax | 323-752-0710
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Provider Business Mailing Address
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Address Line | 7301 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90047-2254
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Country | US
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Telephone | 323-752-1692
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Fax | 323-752-0710
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARTHA TUMBAN
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Credential |
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Telephone | 323-752-1692
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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 | PHY 32368
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 48238
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License Number State | CA
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