Organization
SEAGATE HEALTH ENTERPRISES INC.
Active
Other names
San Pedro Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VISHAL PATEL PHARMD (PHARMACIST IN CHARGE)
(310) 831-0155
Entity
Organization
Contact information
Practice address
1360 W 6TH ST, SUITE 115, SAN PEDRO, CA 90732-3514
(310) 831-0155
(310) 831-6654
Mailing address
1360 W 6TH ST, SUITE 115, SAN PEDRO, CA 90732-3514
(310) 831-0155
(310) 831-6654
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY51898
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY51898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA441510
—
CA
Enumeration date
05/22/2006
Last updated
09/18/2014
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