Organization
MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE HILL RPH (OWNER PHARMACIST)
(626) 285-2206
Entity
Organization
Contact information
Practice address
702 S DEL MAR AVE, SAN GABRIEL, CA 91776-2440
(626) 285-2206
(626) 285-6745
Mailing address
702 S DEL MAR AVE, SAN GABRIEL, CA 91776-2440
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY360660
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500086
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA360660
—
CA
Enumeration date
08/31/2006
Last updated
03/07/2023
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