MEDICARE: MARINA 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	PHY45093	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134119423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARINA PHARMACY INC.

Provider Business Mailing Address
First Line	:	1145 ARTESIA BLVD
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-6900
Country	:	US
Telephone Number	:	310-376-9456
Fax Number	:	310-376-6026

Provider Business Practice Location Address
First Line	:	1145 ARTESIA BLVD
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-6900
Country	:	US
Telephone Number	:	310-376-9456
Fax Number	:	310-376-6026

Authorized Official
Title or Position	:	PRES.
Name	:	DR. RONALD KEITH OTTO
Credential	:	PHARM.D.
Telephone Number	:	310-376-9456

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	02/26/2008

Similar Medicare Providers

1770689259 — MARIA I ANDRAKOVICH MD
Practice Location Address:

6900 S DIXIE HWY
WEST PALM BEACH, FL
33405-4612

Practice Phone: 561-389-1331
Practice Fax:

1700104395 — PRO FITNESS PHYSICAL THERAPY, CORP
Practice Location Address:

6900 BAY DR APT 9G
MIAMI BEACH, FL
33141-5464

Practice Phone: 786-704-6701
Practice Fax: 305-428-2698

1790075760 — WAL-MART STORES EAST LP
Practice Location Address:

6712 US HIGHWAY 98 W
SANTA ROSA BEACH, FL
32459-6900

Practice Phone: 850-622-1319
Practice Fax:

1225382674 — BRAD E. OREN, MD PA
Practice Location Address:

8198 S JOG RD , SUITE 102
BOYNTON BEACH, FL
33472-6900

Practice Phone: 561-433-0098
Practice Fax: 561-433-4775

1942609805 — MR. ROBERT STEPHEN LAMOTTE R.PH
Practice Location Address:

6712 US HIGHWAY 98 W
SANTA ROSA BEACH, FL
32459-6900

Practice Phone: 850-622-1319
Practice Fax:

1053913343 — STACY MUSICK PHARMD
Practice Location Address:

6712 US HIGHWAY 98 W
SANTA ROSA BEACH, FL
32459-6900

Practice Phone: 850-622-1319
Practice Fax:

Directions to “MARINA PHARMACY INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.