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Organization

MTM PHARMA INC

Active
Other names
PROFESSIONAL PHARMACY SANTA ANA
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DENISE T LE RPH (PRESIDENT/PIC)
(714) 278-4800
Entity
Organization

Contact information

Practice address
2339 W 1ST ST, SANTA ANA, CA 92703-3503
(714) 278-4800
(714) 278-4769
Mailing address
2339 W 1ST ST, SANTA ANA, CA 92703-3503
(714) 278-4800
(714) 278-4769

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHY 51823
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1659797421
CA
01
PHY51823
BOARD OF PHARMACY
CA
Enumeration date
03/17/2014
Last updated
07/07/2023
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