Organization
MINI PHARMACY ENTERPRISES, INC
Active
Other names
Mini Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON M. CHOU (CEO)
(626) 977-0667
Entity
Organization
Contact information
Practice address
2425 PORTER ST, LOS ANGELES, CA 90021-2510
(888) 545-6464
(800) 280-2939
Mailing address
2425 PORTER ST, LOS ANGELES, CA 90021-2510
(888) 545-6464
(800) 280-2939
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0572138
NCPDP-3RD PARTIES
CA
05
—
PHA212940
—
CA
Enumeration date
11/28/2006
Last updated
10/21/2022
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