Organization
INTERCARE HEALTH SYSTEMS INC
Active
Other names
CITY OF ANGELS MED CTR PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
MAI THAI (DIRECTOR OF PHARMACY)
(213) 484-3501
Entity
Organization
Contact information
Practice address
1711 W TEMPLE ST, LOS ANGELES, CA 90026-5421
(213) 484-3580
(213) 484-3532
Mailing address
1711 W TEMPLE ST, LOS ANGELES, CA 90026-5421
(213) 484-3580
(213) 484-3532
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
HSP43766
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5600057
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
HSC30725
—
CA
05
—
HSP40275F
—
CA
Enumeration date
04/25/2007
Last updated
07/28/2010
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