San Jacinto Pharmacy

LBN: Gene Kim
San Jacinto Pharmacy is an health care organization with primary practice located at 100 E Main St , San Jacinto CA 92583-4228. 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. Gene Kim can be contacted via phone (951) 654-9393, or through Kim, Gene via phone (951) 654-9393.

Contact Information

Primary practice address
100 E Main St San Jacinto CA 92583-4228
Phone: (951) 654-9393
Fax: (951) 654-9394
Website:
Map and Directions
Authorized official contact:
Name: Kim, Gene PHARMD
Phone: (951) 654-9393

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY46375 California

Profile Details

NPI number 1043322092
LBN Legal business name Gene Kim
DBA Doing business as San Jacinto Pharmacy
Authorized official Kim, Gene PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2006
Last updated Sep 28th, 2016 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043322092 NPPES
Other 1997444 PK
MEDICAID PHA463750 PK

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