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Organization
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA
Active
Organization
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA
Active
Other names
PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 303-5777
(310) 303-5778
Mailing address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 303-5722
(310) 303-5779
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
HSP47224
CA
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997017
PK
—
Enumeration date
07/24/2006
Last updated
05/09/2025
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