Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
GOOD SAMARITAN PHARMACY INC
Active
Organization
GOOD SAMARITAN PHARMACY INC
Active
Other names
Good Samaritan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MYLENE BUNAGAN (CEO)
(909) 305-0358
Entity
Organization
Contact information
Practice address
629 W COVINA BLVD, SAN DIMAS, CA 91773-2913
(909) 305-0358
(909) 394-5649
Mailing address
629 W COVINA BLVD, SAN DIMAS, CA 91773-2913
(909) 305-0358
(909) 394-5649
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
PHY55628
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169225
PK
—
Enumeration date
11/15/2006
Last updated
07/19/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers