The Medicine Shoppe

LBN: Magic Potion Inc
The Medicine Shoppe is an health care organization with primary practice located at 24602 Raymond Way Suite B, Lake Forest CA 92630-4461. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Magic Potion Inc can be contacted via phone (949) 830-8500, or through Soskin, Gennady via phone (949) 830-8500.

Contact Information

Primary practice address
24602 Raymond Way Suite B Lake Forest CA 92630-4461
Phone: (949) 830-8500
Fax: (949) 830-9884
Website:
Map and Directions
Authorized official contact:
Name: Soskin, Gennady PHARM.D.
Phone: (949) 830-8500

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHY47205 California

Profile Details

NPI number 1912062332
LBN Legal business name Magic Potion Inc
DBA Doing business as The Medicine Shoppe
Authorized official Soskin, Gennady PHARM.D.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 26th, 2006
Last updated Mar 7th, 2023 - about last year

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 1912062332 NPPES
California MEDICAID PHA472050
California Other 0528034

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