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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