Organization
PRIMECARE PHARMACY INC
Active
Other names
Martin Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE KIM (CEO)
(213) 382-9718
Entity
Organization
Contact information
Practice address
801 S. VERMONT AVE, STE 104, LOS ANGELES, CA 90005-1567
(213) 382-9718
(213) 380-6792
Mailing address
801 S. VERMONT AVE, STE 104, LOS ANGELES, CA 90005-1567
(213) 382-9718
(213) 380-6792
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY44391
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997466
PK
—
05
—
PHA443910
—
CA
Enumeration date
08/31/2006
Last updated
03/05/2021
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