MEDICARE: C STUART 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	3336C0003X	Community/Retail Pharmacy	19740	CA

General Provider Information

NPI Number	:	1902950561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C STUART INC

Provider Business Mailing Address
First Line	:	PO BOX 2748
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-1748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6880 E 10TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4930
Country	:	US
Telephone Number	:	562-810-2735
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHARLES C STUART
Credential	:	BPHARM
Telephone Number	:	562-810-2735

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	01/18/2016

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