Organization
MAIN STREET PHARMACY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMELIA GRACE GINES PADILLA RPH (PHARMACIST IN CHARGE)
(951) 279-3125
Entity
Organization
Contact information
Practice address
823 S MAIN ST STE 102, CORONA, CA 92882-3409
(951) 279-3125
(951) 279-3127
Mailing address
823 S MAIN ST STE 102, CORONA, CA 92882-3409
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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