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General NPI Number Information
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NPI Number | 1811034200
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHARMACY
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 10401 LAKEWOOD BLVD
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City | DOWNEY
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State | CA
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Zip | 90241-2744
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Country | US
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Telephone | 562-869-0965
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Fax | 562-869-8135
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Provider Business Mailing Address
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Address Line | 10401 LAKEWOOD BLVD
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City | DOWNEY
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State | CA
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Zip | 90241-2744
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Country | US
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Telephone | 562-869-0965
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Fax | 562-869-8135
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. RONALD YOUNG-SOARES
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Credential | RPH
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Telephone | 562-869-0965
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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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