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Organization
INTERCARE HEALTH SYSTEMS INC
Active
Organization
INTERCARE HEALTH SYSTEMS INC
Active
Other names
CITY OF ANGELS MED CTR PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
MAI THAI (DIRECTOR OF PHARMACY)
(213) 484-3501
Entity
Organization
Contact information
Practice address
1711 W TEMPLE ST, LOS ANGELES, CA 90026-5421
(213) 484-3580
(213) 484-3532
Mailing address
1711 W TEMPLE ST, LOS ANGELES, CA 90026-5421
(213) 484-3580
(213) 484-3532
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
HSP43766
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5600057
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
HSC30725
—
CA
05
—
HSP40275F
—
CA
Enumeration date
04/25/2007
Last updated
07/28/2010
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