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General NPI Number Information
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NPI Number | 1952457418
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Entity Type | Organization
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Legal Business Name | CENTRAL COMMUNITY PHARMACY, INC.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2701 S CENTRAL AVE
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City | LOS ANGELES
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State | CA
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Zip | 90011-5527
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Country | US
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Telephone | 323-846-1800
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Fax | 323-846-1866
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Provider Business Mailing Address
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Address Line | 2701 S CENTRAL AVE
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City | LOS ANGELES
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State | CA
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Zip | 90011-5527
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Country | US
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Telephone | 323-846-1800
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Fax | 323-846-1866
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Authorized Official
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Title or Position | CEO, PHARMACIST IN CHARGE, OWNER
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Name | MR. OSAMA (SAM) M. SHOKAIR
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Credential | R.PH.
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Telephone | 323-846-1800
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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 | PHY 47177
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License Number State | CA
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