Organization
CANTWELL MEDICAL PHARMACY INC
Active
Other names
CANTWELL MEDICAL PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ARIC HONDA (OWNER PHCST)
(626) 357-9959
Entity
Organization
Contact information
Practice address
931 BUENA VISTA ST, STE 104, DUARTE, CA 91010-1712
(626) 357-9959
(626) 305-6608
Mailing address
931 BUENA VISTA ST, STE 104, DUARTE, CA 91010-1712
(626) 357-9959
(626) 305-6608
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY32531
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0574360
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA325310
—
CA
Enumeration date
11/07/2006
Last updated
03/07/2011
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