Provider Demographics
NPI:1275713141
Name:LM PHARMACY INC
Entity Type:Organization
Organization Name:LM PHARMACY INC
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:BAKER
Authorized Official - Last Name:WANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-743-1839
Mailing Address - Street 1:11003 LAKEWOOD BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3809
Mailing Address - Country:US
Mailing Address - Phone:562-869-9200
Mailing Address - Fax:562-869-9231
Practice Address - Street 1:11003 LAKEWOOD BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3809
Practice Address - Country:US
Practice Address - Phone:562-869-9200
Practice Address - Fax:562-869-9231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
CA488373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY57248OtherPHARMACY LICENSE
CA5628687OtherNCPDP #
CAPHY48837Medicare PIN
CAFC1627338OtherDEA