Organization
LIFETIME PHARMACY RX INC
Active
Other names
Cal-Hills Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ANTHONY MARIANO FRANCISCO (CEO)
(562) 448-0933
Entity
Organization
Contact information
Practice address
347 E LA HABRA BLVD, LA HABRA, CA 90631-5439
(562) 448-0933
(562) 448-3090
Mailing address
3121 W COAST HWY APT 6D, NEWPORT BEACH, CA 92663-4071
(951) 442-3724
(562) 448-3090
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5669001
NCPDP
CA
Enumeration date
03/08/2019
Last updated
03/07/2023
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