Modernhealth Specialty (px), Llc

NPI 1013913458 - Pharmacy - 3336C0003X

NPI Details
NPI 1013913458
Enumeration Date 06/21/2005
Last Updated 01/26/2015
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name DOMENIC DOMENIC
Position PRESIDENT/CEO
Phone (818) 769-0313
Fax (818) 769-0026
Practice Location
7373 LINCOLN WAY
GARDEN GROVE CA, 92841, US
Phone (818) 769-0313
Fax (818) 769-0026
Business Location
7373 LINCOLN WAY
GARDEN GROVE CA, 92841-1428, US
Phone (818) 769-0313
Fax (818) 769-0026
Toxanomy
Taxonomy Code 3336C0003X
License State California
License Number PHY50999
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According to our database, Modernhealth Specialty (px), Llc NPI is 1013913458, taxonomy code is 3336C0003X and license number is PHY50999, license state is located at California. Modernhealth Specialty (px), Llc physically located at 7373 Lincoln Way, Garden Grove CA, 92841. NPI Number 1033115704 has the healthcare provider type.

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1013913458 NPI number is provided on an as is basis without warranty of any kind. 1013913458 is maintained by the National Plan & Provider Enumeration System. The contents of Modernhealth Specialty (px), Llc are for informational purposes only.