Provider Demographics
NPI:1376887166
Name:SANTA MARIA PHARMACY INC
Entity Type:Organization
Organization Name:SANTA MARIA PHARMACY INC
Other - Org Name:SANTA MARIA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:909-993-0240
Mailing Address - Street 1:2288 S GAREY AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-5645
Mailing Address - Country:US
Mailing Address - Phone:909-993-0240
Mailing Address - Fax:909-993-0249
Practice Address - Street 1:2288 S GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-5645
Practice Address - Country:US
Practice Address - Phone:909-993-0240
Practice Address - Fax:909-993-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY515853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142328OtherPK