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Organization

MI ENTERPRISES LLC

Active
Other names
ST MONICA PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MARVEL JULY (PRES)
(741) 527-6078
Entity
Organization

Contact information

Practice address
8575 KNOTT AVE, STE D, BUENA PARK, CA 90620-3850
(714) 527-6078
(714) 527-7185
Mailing address
8575 KNOTT AVE, STE D, BUENA PARK, CA 90620-3850
(714) 527-6078
(714) 527-7185

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHY48675
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5630872
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
02/25/2008
Last updated
09/23/2010
About Stedi
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  • EDI platform