Organization
SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER
Active
Other names
LLUMC Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR WRIGHT (CHIEF EXECUTIVE OFFICER)
(909) 558-5075
Entity
Organization
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4500
(909) 558-0362
Mailing address
11234 ANDERSON ST RM 1147, LOMA LINDA, CA 92354-2804
(909) 558-5075
(909) 558-8773
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY50973
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0555093
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHB137960
—
CA
Enumeration date
07/24/2006
Last updated
03/08/2022
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