1639184252 NPI number — WHITTIER COMMUNITY PHARMACY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639184252 NPI number — WHITTIER COMMUNITY PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHITTIER COMMUNITY PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639184252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8135 PAINTER AVE
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
WHITTIER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90602-3158
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-945-2325
Provider Business Mailing Address Fax Number:
562-698-3207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8135 PAINTER AVE
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
WHITTIER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90602-3158
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-945-2325
Provider Business Practice Location Address Fax Number:
562-698-3207
Provider Enumeration Date:
07/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
VP PHARMCIST
Authorized Official Telephone Number:
562-945-2325

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PHY37856 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PHA378560 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0589551 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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