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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