Organization
ST MARY PHARMACY INC
Active
Other names
ST MARY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BESHOY I GERGES PHARM D (PRESIDENT/PIC)
(818) 975-8004
Entity
Organization
Contact information
Practice address
8254 WHITE OAK AVE UNIT 4, NORTHRIDGE, CA 91325-4367
(818) 975-8004
(818) 975-8094
Mailing address
8254 WHITE OAK AVE UNIT 4, NORTHRIDGE, CA 91325-4367
(818) 975-8004
(818) 975-8094
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
56096
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY56096
BOARD OF PHARMACY PERMIT
CA
Enumeration date
04/24/2018
Last updated
02/03/2022
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