Organization
PINE DRUG INC
Active
Other names
South Main Aloha Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DANG (PHARMACY MANAGER)
(714) 839-1267
Entity
Organization
Contact information
Practice address
618 S MAIN ST, SANTA ANA, CA 92701-5716
(714) 676-2078
(714) 676-2079
Mailing address
618 S MAIN ST, SANTA ANA, CA 92701-5716
(714) 676-2078
(714) 839-5871
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
53628
CA
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003201328
—
CA
01
—
2154303
PK
—
Enumeration date
04/02/2015
Last updated
11/29/2022
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