Organization
MARINA PHARMACY INC.
Active
Other names
dba Hillside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD KEITH OTTO PHARM.D. (PRES.)
(310) 376-9456
Entity
Organization
Contact information
Practice address
1145 ARTESIA BLVD, MANHATTAN BEACH, CA 90266-6900
(310) 376-9456
(310) 376-6026
Mailing address
1145 ARTESIA BLVD, MANHATTAN BEACH, CA 90266-6900
(310) 376-9456
(310) 376-6026
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY45093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA450930
—
CA
Enumeration date
10/26/2005
Last updated
02/26/2008
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