# MODERNHEALTH HOLDINGS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Modern Health Pharmacy - SD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508094558
- **Authorized official:** SHANNON CHOU (DIRECTOR, BUSINESS OPERATIONS)
- **Authorized official phone:** (626) 932-1721

## Contact information

- **Practice address:** 13220 EVENING CREEK DR S, STE 110, SAN DIEGO, CA 92128-4103
- **Practice address phone:** (858) 668-3350
- **Practice address fax:** (858) 668-3352
- **Mailing address:** 110 E HUNTINGTON DR, MONROVIA, CA 91016-3415
- **Mailing address phone:** (858) 668-3350
- **Mailing address fax:** (858) 668-3352

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHY51002 | CA | Yes |

## Other

- **Enumeration date:** 06/29/2009
- **Last updated:** 04/19/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1508094558 | — | CA |
| 01 | — | 2121362 | PK | — |