Organization
LONG BEACH MEMORIAL MEDICAL
Active
Organization
LONG BEACH MEMORIAL MEDICAL
Active
Other names
Infusion Care Pharmacy South
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS FINCH (CHIEF COMPLIANCE OFFICER)
(714) 377-3218
Entity
Organization
Contact information
Practice address
23521 PASEO DE VALENCIA, STE B-1, LAGUNA HILLS, CA 92653
(949) 460-1610
(949) 458-0554
Mailing address
PO BOX 20359, LONG BEACH, CA 90801-3359
(562) 933-3282
(562) 933-0014
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHY40530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1996335
PK
—
05
—
PHA40530
—
CA
Enumeration date
09/12/2006
Last updated
08/23/2018
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