Organization
ST. JOHN'S COMMUNITY HEALTH
Active
Organization
ST. JOHN'S COMMUNITY HEALTH
Active
Other names
St. John's Well Child and Family Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PETER TAWFIK RPH (CHIEF PHARMACY OFFICER)
(615) 957-8115
Entity
Organization
Contact information
Practice address
808 W 58TH ST RM 123, LOS ANGELES, CA 90037-3632
(323) 541-1400
(323) 541-1401
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1400
(323) 541-1401
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY54305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154951
PK
—
Enumeration date
10/20/2015
Last updated
01/21/2025
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