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General NPI Number Information
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NPI Number | 1467834580
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Entity Type | Organization
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Legal Business Name | ST CYRIL INC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 1525 MESA VERDE DR E STE 101
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City | COSTA MESA
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State | CA
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Zip | 92626-5221
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Country | US
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Telephone | 714-884-3574
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Fax | 714-486-1027
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Provider Business Mailing Address
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Address Line | 1525 MESA VERDE DR E STE 101
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City | COSTA MESA
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State | CA
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Zip | 92626-5221
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Country | US
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Telephone | 714-884-3574
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Fax | 714-486-1027
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | GENEVIEVE BENJAMIN
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Credential | PHARM D
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Telephone | 949-293-9857
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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 | 3336H0001X
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Taxonomy Name | Home Infusion Therapy 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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY56036
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License Number State | CA
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