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General NPI Number Information
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NPI Number | 1689414120
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Entity Type | Organization
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Legal Business Name | EL SEGUNDO PHARMACY INC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 827 N DOUGLAS ST
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City | EL SEGUNDO
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State | CA
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Zip | 90245-2801
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Country | US
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Telephone | 424-321-8273
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Fax |
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Provider Business Mailing Address
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Address Line | 827 N DOUGLAS ST
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City | EL SEGUNDO
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State | CA
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Zip | 90245-2801
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Country | US
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Telephone | 424-321-8273
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER O'KEEFE
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Credential |
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Telephone | 424-321-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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