Organization
GOOD SAMARITAN PHARMACY INC
Active
Other names
Good Samaritan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MYLENE BUNAGAN (CEO)
(909) 305-0358
Entity
Organization
Contact information
Practice address
629 W COVINA BLVD, SAN DIMAS, CA 91773-2913
(909) 305-0358
(909) 394-5649
Mailing address
629 W COVINA BLVD, SAN DIMAS, CA 91773-2913
(909) 305-0358
(909) 394-5649
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY55628
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169225
PK
—
Enumeration date
11/15/2006
Last updated
07/19/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us