Organization
ST. JOSEPH PHARMACY, INC.
Active
Other names
Creative Rx Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP A ETTEDGUI PHARMD (CEO)
(818) 259-5375
Entity
Organization
Contact information
Practice address
2519 W BURBANK BLVD, BURBANK, CA 91505-2302
(818) 736-5290
(818) 736-5276
Mailing address
2519 W BURBANK BLVD, BURBANK, CA 91505-2302
(818) 736-5290
(818) 736-5276
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
56040
CA
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
56040
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175758
PK
—
Enumeration date
02/19/2018
Last updated
03/19/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us