=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750396230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIFE CARE PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2006
-----------------------------------------------------
Last Update Date | 09/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 947 S ANAHEIM BLVD STE 108
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92805-5582
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-533-2157
-----------------------------------------------------
Fax | 714-533-7054
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 947 S ANAHEIM BLVD STE 108
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92805-5582
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-533-2157
-----------------------------------------------------
Fax | 714-533-7054
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | LOURDES MALILAY
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 714-533-2157
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY45969
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------