Organization
TRUE VINE PHARMACY INC
Active
Other names
Cal Med Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKEL ABDELNOUR ABDELMESSIH PHARM D (PRESIDENT/CEO/CFO/SECRETARY/DIRECTO)
(562) 513-3012
Entity
Organization
Contact information
Practice address
1598 LONG BEACH BLVD, STE 102, LONG BEACH, CA 90813-2384
(562) 513-3012
(562) 513-3011
Mailing address
1598 LONG BEACH BLVD, STE 102, LONG BEACH, CA 90813-2384
(562) 513-3012
(562) 513-3011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY54479
CA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160946
PK
—
Enumeration date
07/22/2016
Last updated
12/20/2023
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