# GOOD SAMARITAN PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Good Samaritan Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538231311
- **Authorized official:** MYLENE BUNAGAN (CEO)
- **Authorized official phone:** (909) 305-0358

## Contact information

- **Practice address:** 629 W COVINA BLVD, SAN DIMAS, CA 91773-2913
- **Practice address phone:** (909) 305-0358
- **Practice address fax:** (909) 394-5649
- **Mailing address:** 629 W COVINA BLVD, SAN DIMAS, CA 91773-2913
- **Mailing address phone:** (909) 305-0358
- **Mailing address fax:** (909) 394-5649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHY55628 | CA | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 07/19/2018