Organization
CANTWELL MEDICAL PHARMACY INC
Active
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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