# MATDAN LJ INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MERCY CARE PHARMACY
- **Other names:** Mercy Care Pharmacy Home LTC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104645712
- **Legal business name:** MERCY CARE PHARMACY
- **Authorized official:** BASSAM MASSAAD RPH (OWNER)
- **Authorized official phone:** (760) 294-0014

## Contact information

- **Practice address:** 488 E VALLEY PKWY STE 101, ESCONDIDO, CA 92025-3324
- **Practice address phone:** (760) 294-0014
- **Practice address fax:** (760) 294-0066
- **Mailing address:** 488 E VALLEY PKWY STE 101, ESCONDIDO, CA 92025-3324
- **Mailing address phone:** (760) 294-0014
- **Mailing address fax:** (760) 294-0066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/09/2024
- **Last updated:** 10/17/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 51469 | BOARD OF PHARMACY | CA |