Organization
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA
Active
Other names
PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 303-5777
(310) 303-5778
Mailing address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 303-5722
(310) 303-5779
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
HSP47224
CA
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997017
PK
—
Enumeration date
07/24/2006
Last updated
05/09/2025
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