Organization
JMC PHARMACY, INC.
Active
Other names
ABC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN MICHAEL CHAN PHARMD (OWNER)
(951) 299-9922
Entity
Organization
Contact information
Practice address
777 W BLAINE ST, RIVERSIDE, CA 92507-3940
(951) 299-9922
Mailing address
777 W BLAINE ST, RIVERSIDE, CA 92507-3940
(951) 299-9922
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY50858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5644249
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/26/2012
Last updated
02/07/2021
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