Peninsula Pharmacy

LBN: Peninsula Pharmacy
Peninsula Pharmacy is an health care organization with primary practice located at 1294 W 6Th St Ste 100 , San Pedro CA 90731-2997. 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. Peninsula Pharmacy can be contacted via phone (310) 833-3535, or through Elie, Shahram via phone (310) 833-3535.

Contact Information

Primary practice address
1294 W 6Th St Ste 100 San Pedro CA 90731-2997
Phone: (310) 833-3535
Fax: (310) 833-9124
Website:
Map and Directions
Authorized official contact:
Name: Elie, Shahram RPH
Phone: (310) 833-3535

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY36626 California

Profile Details

NPI number 1710920079
LBN Legal business name Peninsula Pharmacy
DBA Doing business as Peninsula Pharmacy
Authorized official Elie, Shahram RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 19th, 2018 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1710920079 NPPES
California MEDICAID PHA3662460
California Other 1993007

Popular Providers