Mendocino Coast Pharmacy

LBN: Mendocino Pharmacy Holdings Inc.
Mendocino Coast Pharmacy is an health care organization with primary practice located at 350 Cypress St , Fort Bragg CA 95437-5408. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Mendocino Pharmacy Holdings Inc. can be contacted via phone (707) 962-0800, or through Brodetsky, Kelly E via phone (707) 734-0091.

Contact Information

Primary practice address
350 Cypress St Fort Bragg CA 95437-5408
Phone: (707) 962-0800
Fax: (707) 962-3011
Website:
Map and Directions
Authorized official contact:
Name: Brodetsky, Kelly E PHARMD
Phone: (707) 734-0091

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1619216173
LBN Legal business name Mendocino Pharmacy Holdings Inc.
DBA Doing business as Mendocino Coast Pharmacy
Authorized official Brodetsky, Kelly E PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 4th, 2013
Last updated Jul 23rd, 2020 - about 5 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 1619216173 NPPES
Other 5646469 NCPDP PROVIDER IDENTIFICATION NUMBER

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