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NPI Code Detail

MEDICARE: MAJESTIC PHARMACY INC

MEDICARE: MAJESTIC 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
13336C0003XCommunity/Retail Pharmacy55859CA
23336C0003XCommunity/Retail Pharmacy
33336L0003XLong Term Care Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
157982OTHERCASTATE BOARD OF PHARMACY PERMIT
255859OTHERCASTATE BOARD OF PHARMACY PERMIT

General Provider Information

NPI Number : 1154835973
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAJESTIC PHARMACY INC
Provider Business Mailing Address
First Line : 7283 ENGINEER RD STE D
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1414
Country : US
Telephone Number : 858-598-5600
Fax Number : 858-598-5619
Provider Business Practice Location Address
First Line : 7283 ENGINEER RD STE D
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1414
Country : US
Telephone Number : 619-280-1254
Fax Number : 619-280-1255
Authorized Official
Title or Position : CEO/CFO/SEC./DIR.
Name : MS. MARIAN MIRANDA
Credential :
Telephone Number : 310-462-5025
Provider Enumeration Date : 12/01/2017
Last Update Date : 01/18/2021

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Directions to “MAJESTIC PHARMACY INC ” Practice Location

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