Provider Demographics
NPI:1427103878
Name:CHEMIQUE PHARMACEUTICALS, INC.
Entity type:Organization
Organization Name:CHEMIQUE PHARMACEUTICALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:MILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:562-698-0921
Mailing Address - Street 1:PO BOX 4369
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90607-4369
Mailing Address - Country:US
Mailing Address - Phone:909-598-1010
Mailing Address - Fax:909-594-4205
Practice Address - Street 1:176 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-4300
Practice Address - Country:US
Practice Address - Phone:909-598-1229
Practice Address - Fax:909-594-4205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALSC99028332BP3500X, 3336C0004X, 3336H0001X, 3336S0011X
CAPHY366753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA366750Medicaid
CAPHA366750Medicaid