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General NPI Number Information
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NPI Number | 1932728433
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Entity Type | Organization
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Legal Business Name | EMJ PHARMACY CORPORATION
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 665 CAMINO DE LOS MARES STE 101
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2840
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Country | US
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Telephone | 949-496-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 665 CAMINO DE LOS MARES STE 101
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2840
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Country | US
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Telephone | 949-496-0123
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE MEDLEY
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Credential |
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Telephone | 949-496-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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