Provider Demographics
NPI:1013367002
Name:LOS ANGELES COUNTY, SHERIFF'S DEPT. MEDICAL SERVICES BUREAU, PHARMACY
Entity Type:Organization
Organization Name:LOS ANGELES COUNTY, SHERIFF'S DEPT. MEDICAL SERVICES BUREAU, PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MEDICAL SERVICES BUREAU
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DINEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-893-5510
Mailing Address - Street 1:450 BAUCHET STREET,
Mailing Address - Street 2:MEDICAL SERVICES BUREAU PHARMACY ROOM # M4137
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2907
Mailing Address - Country:US
Mailing Address - Phone:213-893-5566
Mailing Address - Fax:323-415-1299
Practice Address - Street 1:450 BAUCHET ST
Practice Address - Street 2:MEDICAL SVCS BUREAU PHARMACY ROOM #C M4137
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2907
Practice Address - Country:US
Practice Address - Phone:213-893-5566
Practice Address - Fax:323-415-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31791311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home