Organization
ST JOHNS PHARMACY CORP
Active
Other names
ST JOHNS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA KIM (PRESIDENT)
(951) 217-9705
Entity
Organization
Contact information
Practice address
10181 HOLE AVE, RIVERSIDE, CA 92503-3441
(951) 785-6464
(951) 687-7660
Mailing address
10181 HOLE AVE, RIVERSIDE, CA 92503-3441
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY47457
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5618066
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA474570
—
CA
Enumeration date
07/14/2006
Last updated
09/11/2025
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