Station Pharmacy

LBN: Infortel Medical Group
Station Pharmacy is an health care organization with primary practice located at 1820 Wilshire Blvd , Santa Monica CA 90403-5610. 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. Infortel Medical Group can be contacted via phone (310) 892-0468, or through Kong, Eleanor Fam Mai via phone (310) 892-0468.

Contact Information

Primary practice address
1820 Wilshire Blvd Santa Monica CA 90403-5610
Fax: (310) 861-1888
Website:
Authorized official contact:
Name: Kong, Eleanor Fam Mai PHARM D

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PHY 50343 California
Suppliers / Community/Retail Pharmacy 3336C0003X PHY 50343 California

Profile Details

NPI number 1780997619
LBN Legal business name Infortel Medical Group
DBA Doing business as Station Pharmacy
Authorized official Kong, Eleanor Fam Mai PHARM D
Entity Organization
Organization subpart 1 No
Enumeration date Jul 20th, 2010
Last updated Feb 3rd, 2015 - 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 1780997619 NPPES
California MEDICAID PHA465390
California Other PHY 50343

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