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Organization

SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER, INC.

Active
Other names
Loma Linda University Faculty Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KERRY LYNN HEINRICH (CHIEF EXECUTIVE OFFICER)
(909) 558-4308
Entity
Organization

Contact information

Practice address
11370 ANDERSON ST STE 1000, LOMA LINDA, CA 92354-3450
(909) 558-2804
(909) 796-2631
Mailing address
11370 ANDERSON ST STE 1000, LOMA LINDA, CA 92354-3450

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY47302
CA
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1679518815
NPI
CA
01
5617999
OTHER ID NUMBER-COMMERCIAL NUMBER
05
PHA473020
CA
01
PHY47302
CA STATE BOARD OF PHARMACY LICENSE
CA
Enumeration date
06/20/2006
Last updated
05/23/2019
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