Organization
BENSON TOY
Active
Organization
BENSON TOY
Active
Other names
MARIN MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BENSON TOY PHARMD AND CCN (OWNER AND PHARM)
(415) 479-1930
Entity
Organization
Contact information
Practice address
750 LAS GALLINAS AVE, STE 104, SAN RAFAEL, CA 94903-3438
(415) 479-1930
(415) 479-0128
Mailing address
750 LAS GALLINAS AVE, STE 104, SAN RAFAEL, CA 94903-3438
(415) 479-1930
(415) 479-0128
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY37119
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0522575
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA371190
—
CA
Enumeration date
12/18/2006
Last updated
03/05/2012
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