Organization
HAN SAM CORP
Active
Other names
River's Edge Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HANY SAMUEL BENJAMIN (CEO)
(949) 292-2686
Entity
Organization
Contact information
Practice address
16782 VON KARMAN AVE STE 12, IRVINE, CA 92606-2417
(949) 393-5780
(949) 393-5790
Mailing address
16782 VON KARMAN AVE STE 12, IRVINE, CA 92606-2417
(949) 393-5780
(949) 393-5790
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
51942
CA
3336H0001X
Home Infusion Therapy Pharmacy
Primary
51942
CA
3336S0011X
Specialty Pharmacy
51942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508315128
—
CA
Enumeration date
09/23/2016
Last updated
02/07/2025
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