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NPI Code Detail

MEDICARE: MERCED MEDICAL PHARMACY INC

MEDICARE: MERCED MEDICAL 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
1333600000XPharmacyPHY19902CA
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20507270OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1740365030
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCED MEDICAL PHARMACY INC
Provider Business Mailing Address
First Line : 1515 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3403
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1515 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3403
Country : US
Telephone Number : 626-962-3685
Fax Number : 626-962-3515
Authorized Official
Title or Position : PRESIDENT
Name : GEORGE FURUTA
Credential :
Telephone Number : 626-962-3685
Provider Enumeration Date : 10/26/2006
Last Update Date : 09/11/2025

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Directions to “MERCED MEDICAL PHARMACY INC ” Practice Location

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