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NPI Code Detail

MEDICARE: PARTNER HEALTHCARE, INC.

MEDICARE: PARTNER HEALTHCARE, 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
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy51078CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12137769OTHERPK

General Provider Information

NPI Number : 1144455999
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARTNER HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 2035 S MYRTLE AVE
Second Line :
City : MONROVIA
State : CA
Zip : 91016-4836
Country : US
Telephone Number : 626-448-4085
Fax Number : 626-448-8197
Provider Business Practice Location Address
First Line : 2035 S MYRTLE AVE
Second Line :
City : MONROVIA
State : CA
Zip : 91016-4836
Country : US
Telephone Number : 626-448-4085
Fax Number : 626-448-8197
Authorized Official
Title or Position : CEO
Name : KHANH-LONG THAI
Credential :
Telephone Number : 626-448-4085
Provider Enumeration Date : 05/22/2009
Last Update Date : 10/24/2019

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