Organization
CALIFORNIA SPECIALTY PHARMACY LLC
Active
Other names
California Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE WORTHINGTON KRIDNER IV PHARMD (PRESIDENT/CEO)
(714) 981-6871
Entity
Organization
Contact information
Practice address
12110 HADLEY ST STE B, WHITTIER, CA 90601-3912
(877) 802-7779
(866) 853-6555
Mailing address
12110 HADLEY ST STE B, WHITTIER, CA 90601-3912
(877) 802-7779
(866) 853-6555
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PMP-666
HI
333600000X
Pharmacy
PH24882
FL
3336C0003X
Community/Retail Pharmacy
54320
CA
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101349024
—
CA
05
—
1114239332
—
CA
01
—
2125569
PK
—
01
—
550007732
STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - HOME HEALTH
CA
01
—
7485260001
MEDICARE PTAN
CA
Enumeration date
07/02/2010
Last updated
12/30/2025
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