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General NPI Number Information
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NPI Number | 1730658295
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Entity Type | Organization
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Legal Business Name | M & S PHARMACY
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 4561 S CENTINELA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90066-6248
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Country | US
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Telephone | 310-822-6354
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Fax | 310-822-6540
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Provider Business Mailing Address
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Address Line | 4561 S CENTINELA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90066-6248
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Country | US
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Telephone | 310-822-6354
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Fax | 310-822-6540
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Authorized Official
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Title or Position | OWNER
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Name | CARRIE OTANI
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Credential | PHARMD, PIC
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Telephone | 310-822-6354
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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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