Organization
CALIFORNIA SPECIALTY PHARMACY LLC
Active
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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