Organization
CLINISHARE PHARMACY INC
Active
Other names
CLINISHARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUTHIDA CHEA RPH (PRESIDENT/PIC)
(818) 835-9627
Entity
Organization
Contact information
Practice address
23719 ROSCOE BLVD, WEST HILLS, CA 91304-3041
(818) 835-9627
(818) 835-9673
Mailing address
23719 ROSCOE BLVD, WEST HILLS, CA 91304-3041
(818) 835-9627
(818) 835-9673
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY46268
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0589676
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/26/2006
Last updated
04/12/2011
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