Organization
STATE OF CALIFORNIA
Active
Other names
STUDENT HLTH SRVC CSU LONG BCH
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY CHEN (PHARMACY MANAGER)
(562) 985-1561
Entity
Organization
Contact information
Practice address
1250 N BELLFLOWER BLVD, LONG BEACH, CA 90840-0004
(562) 985-1561
(562) 985-8404
Mailing address
1250 N BELLFLOWER BLVD, LONG BEACH, CA 90840-0004
(562) 985-1561
(562) 985-8404
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
PHE14217
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0534974
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
142170
—
CA
Enumeration date
07/22/2006
Last updated
04/23/2010
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