NPI | 1114901014 |
---|---|
Doing Business As | MID WEST MEDICAL PHARMACY |
Entity Type | Organization |
Authorized Contact | TOM SHAFA Owner, PIC, AO 310-657-1635 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY22051) |
Additional Taxonomies | 333600000X Pharmacy |
3336C0004X Pharmacy, Compounding Pharmacy | |
Enumeration Date | 2005-12-04 |
Last Update Date | 2021-12-22 |