111 Pharmacy
LBN: Boonam Shin
111 Pharmacy is an health care organization with primary practice located at 111 W Beverly Blvd Ste B, Montebello CA 90640-4312. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Boonam Shin can be contacted via phone (323) 724-8111, or through Shin, Boonam via phone (323) 742-8111.
Contact Information
Primary practice address
111 W Beverly Blvd Ste B
Montebello CA 90640-4312
Phone: (323) 724-8111
Fax: (323) 724-1754
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Pharmacy | 333600000X | ||
Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY41023 | California |
Profile Details
NPI number | 1821137118 |
---|---|
LBN Legal business name | Boonam Shin |
DBA Doing business as | 111 Pharmacy |
Authorized official | Shin, Boonam RPH |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Feb 5th, 2007 |
Last updated | May 27th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1821137118 | NPPES |
Other | 0523008 | OTHER ID NUMBER | |
MEDICAID | PHA410230 | OTHER ID NUMBER |
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