Provider Demographics
NPI:1124326996
Name:PHARMCO INC
Entity type:Organization
Organization Name:PHARMCO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-272-4767
Mailing Address - Street 1:381 VAN NESS AVE
Mailing Address - Street 2:SUITE 1506, 1509
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-6224
Mailing Address - Country:US
Mailing Address - Phone:310-783-7450
Mailing Address - Fax:310-783-7459
Practice Address - Street 1:381 VAN NESS AVE
Practice Address - Street 2:SUITE 1506, 1509
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-6224
Practice Address - Country:US
Practice Address - Phone:310-783-7450
Practice Address - Fax:310-783-7459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY50313333600000X
CAPHY 50313333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129305OtherPK