MEDICARE: QUALITY SPECIALTY PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PHY 50710	CA
2	3336S0011X	Specialty Pharmacy	PHY 50710	CA
3	3336C0003X	Community/Retail Pharmacy	PHY 50710	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05-14186	OTHER	CA	NCPDP/NABP
2	PHY 50710	OTHER	CA	CALIFORNIA STATE BOARD OF PHARMACY RETAIL PERMIT

General Provider Information

NPI Number	:	1043211725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY SPECIALTY PHARMACY INC

Provider Business Mailing Address
First Line	:	2233 LOMITA BLVD
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-1401
Country	:	US
Telephone Number	:	310-530-2444
Fax Number	:	310-530-8761

Provider Business Practice Location Address
First Line	:	2233 LOMITA BLVD
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-1401
Country	:	US
Telephone Number	:	310-530-2444
Fax Number	:	310-530-8761

Authorized Official
Title or Position	:	SECRETARY
Name	:	MR. VADIM PINHASOV
Credential	:
Telephone Number	:	310-530-2444

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	01/17/2017

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Directions to “QUALITY SPECIALTY PHARMACY INC ” Practice Location

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