# M A JIMENEZ INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Knoll's Prescription Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053596452
- **Authorized official:** MR. MARIO A. JIMENEZ PHARM D. (PHARMACIST/OWNER)
- **Authorized official phone:** (626) 337-1550

## Contact information

- **Practice address:** 14300 RAMONA BLVD, BALDWIN PARK, CA 91706-3241
- **Practice address phone:** (626) 337-1550
- **Practice address fax:** (626) 337-0660
- **Mailing address:** 14300 RAMONA BLVD, BALDWIN PARK, CA 91706-3241
- **Mailing address phone:** (626) 337-1550
- **Mailing address fax:** (626) 337-0660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PHY35802 | CA | Yes |

## Other

- **Enumeration date:** 01/03/2008
- **Last updated:** 09/20/2011