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Provider Information for 1821164146


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WHITE MEMORIAL MEDICAL PLAZA PHARMACY SERVICES INC

Other Names:  
Doing Business As: 
WHITE MEMORIAL MEDICAL PLAZA PHARMACY

Organization Subpart: NO

NPI: 1821164146
Last Updated: 2020-08-21
Certification Date: 2020-08-21

Details

NameValue
NPI1821164146
Enumeration Date2006-11-28
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Mr. PARESHKUMAR PATEL
Title: CEO
Phone: 3232216000
Mailing Address 1701 E CESAR E CHAVEZ AVE
STE 109
LOS ANGELES, CA 90033
United States

Phone: 323-221-6000 | Fax:323-221-0999
 
Primary Practice Address 1701 E CESAR E CHAVEZ AVE
STE 109
LOS ANGELES, CA 90033
United States

Phone: 323-221-6000 | Fax:323-221-0999
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)CA0505187NCPDP NUMBER
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 3336S0011X - Pharmacy - Specialty Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail Pharmacy