Organization
MAGIC POTION INC
Active
Organization
MAGIC POTION INC
Active
Other names
THE MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
GENNADY SOSKIN PHARM.D. (OWNER/PHARMACIST)
(949) 830-8500
Entity
Organization
Contact information
Practice address
24602 RAYMOND WAY, SUITE B, LAKE FOREST, CA 92630-4461
(949) 830-8500
(949) 830-9884
Mailing address
24602 RAYMOND WAY, SUITE B, LAKE FOREST, CA 92630-4461
(949) 830-8500
(949) 830-9884
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0528034
NABP
CA
05
—
PHA472050
—
CA
Enumeration date
12/26/2006
Last updated
03/07/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up