Organization
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA DBA LCM SUBACUTE CARE CTR
Active
Other names
Bay Harbor Rehab. Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER GREENHAM PHARM.D. (PHARMACIST IN CHARGE)
(310) 791-4511
Entity
Organization
Contact information
Practice address
3620 LOMITA BLVD, TORRANCE, CA 90505-3938
(310) 791-4511
(310) 791-4512
Mailing address
3620 LOMITA BLVD, TORRANCE, CA 90505-3938
(310) 791-4511
(310) 791-4512
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
47225
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHB377200
—
CA
Enumeration date
11/22/2005
Last updated
08/22/2020
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