Organization
WEST COVINA MEDICAL CENTER INC
Active
Other names
West Covina Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KOO (PIC)
(626) 502-1991
Entity
Organization
Contact information
Practice address
725 S ORANGE AVE, WEST COVINA, CA 91790-2614
(626) 502-1991
(626) 502-1971
Mailing address
725 S ORANGE AVE, WEST COVINA, CA 91790-2614
(626) 502-1991
(626) 502-1971
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
53643
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160697
PK
—
Enumeration date
07/14/2016
Last updated
04/21/2017
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