Organization
MARIOMINA INC
Active
Other names
EO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MAGED BESHAY (PHARMACIST IN CHARGE)
(909) 837-8560
Entity
Organization
Contact information
Practice address
820 W SAN BERNARDINO RD, COVINA, CA 91722-3622
(626) 446-6088
(626) 446-9399
Mailing address
820 W SAN BERNARDINO RD, COVINA, CA 91722-3622
(626) 446-6088
(626) 446-9399
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY54605
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113683
PK
—
Enumeration date
06/17/2006
Last updated
01/18/2017
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