Organization
ST. MARY HEALTH VENTURES INC
Active
Other names
ATLANTIC PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MCNEALY (CONTROLLER/AO)
(562) 491-9189
Entity
Organization
Contact information
Practice address
1045 ATLANTIC AVE, SUITE 102, LONG BEACH, CA 90813-3408
(562) 491-9799
(562) 491-9058
Mailing address
1045 ATLANTIC AVE, SUITE 102, LONG BEACH, CA 90813-3408
(562) 491-9799
(562) 491-9058
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY41009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991471
PK
—
05
—
PHA410090
—
CA
Enumeration date
09/20/2006
Last updated
02/16/2017
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