# LOMA LINDA HEALTH PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOMA LINDA HEALTH PHARMACY
- **Other names:** LOMA LINDA HEALTH PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699880625
- **Legal business name:** LOMA LINDA HEALTH PHARMACY
- **Authorized official:** SUE PARK RPH (OWNER, PIC)
- **Authorized official phone:** (909) 796-3780

## Contact information

- **Practice address:** 11382 MT. VIEW AVE, LOMA LINDA, CA 92354
- **Practice address phone:** (909) 796-3780
- **Practice address fax:** (909) 796-5783
- **Mailing address:** 11382 MT. VIEW AVE, LOMA LINDA, CA 92354
- **Mailing address phone:** (909) 796-3780
- **Mailing address fax:** (909) 796-5783

## Taxonomy

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

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 05/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2094485 | PK | — |
| 05 | — | PHA394770 | — | CA |