Organization
PEDIATRIC CARE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J LIAUTAUD RPH (PRESIDENT)
(213) 413-2343
Entity
Organization
Contact information
Practice address
4616 DE LONGPRE AVE, LOS ANGELES, CA 90027-6076
(323) 913-5801
(323) 913-5820
Mailing address
4616 DE LONGPRE AVE, LOS ANGELES, CA 90027-6076
(213) 413-2343
(323) 913-5820
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
BP3394397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565905
NABP
CA
05
—
PHA376820
—
CA
Enumeration date
01/17/2006
Last updated
08/22/2020
About Stedi
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