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NPI Code Detail

MEDICARE: MOLINO PHARMACY INC

MEDICARE: MOLINO 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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0002XClinic Pharmacy
33336C0003XCommunity/Retail Pharmacy
43336C0004XCompounding Pharmacy
5333600000XPharmacyPHY54954CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12166186OTHERPK

General Provider Information

NPI Number : 1952843559
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOLINO PHARMACY INC
Provider Business Mailing Address
First Line : 2875 HUNTINGTON DR
Second Line :
City : SAN MARINO
State : CA
Zip : 91108-2220
Country : US
Telephone Number : 562-433-4900
Fax Number : 562-433-7050
Provider Business Practice Location Address
First Line : 2540 E ANAHEIM ST # B
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-3607
Country : US
Telephone Number : 562-433-4900
Fax Number : 562-433-7050
Authorized Official
Title or Position : CEO/PHARMACY MANAGER
Name : ANDREW QUACH
Credential :
Telephone Number : 562-433-4900
Provider Enumeration Date : 11/14/2016
Last Update Date : 01/17/2017

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Directions to “MOLINO PHARMACY INC ” Practice Location

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