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General NPI Number Information
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NPI Number | 1578630836
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Entity Type | Organization
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Legal Business Name | CLINICAL PHARMACIES INC
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 21622 SURVEYOR CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7068
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Country | US
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Telephone | 714-969-6818
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Fax | 714-969-2320
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Provider Business Mailing Address
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Address Line | 21622 SURVEYOR CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7068
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Country | US
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Telephone | 714-969-6818
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Fax | 714-969-2320
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARL WILLIAM GRODACH
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Credential | RPH
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Telephone | 714-969-6818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | W1511
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License Number State | CA
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