Organization
ARTESIA PHARMACY INC
Active
Other names
TRIAD COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD MILLER (PRESIDENT PHARMACIST)
(562) 468-4311
Entity
Organization
Contact information
Practice address
11090 ARTESIA BLVD STE H, CERRITOS, CA 90703-2545
(562) 468-4311
(562) 468-4314
Mailing address
11090 ARTESIA BLVD STE H, CERRITOS, CA 90703-2545
(562) 468-4311
(562) 468-4314
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY41551
CA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114155
PK
—
Enumeration date
06/22/2006
Last updated
12/13/2016
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