Organization
GOOD HEALTH INC
Active
Other names
TOMMIE'S MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN SAMUEL (OWNER)
(714) 961-7930
Entity
Organization
Contact information
Practice address
1041 E YORBA LINDA BLVD, STE 209, PLACENTIA, CA 92870-3728
(714) 993-9370
(714) 572-9453
Mailing address
410 CLOVERLEAF DR, BALDWIN PARK, CA 91706-6511
(714) 993-9370
(714) 572-9453
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47438
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000519
PK
—
05
—
PHA474380
—
CA
Enumeration date
08/31/2006
Last updated
02/17/2015
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