Provider Demographics
NPI:1386013985
Name:MCBEAN PHARMACY, INC.
Entity Type:Organization
Organization Name:MCBEAN PHARMACY, INC.
Other - Org Name:VALENCIA PHARMACY LTC HENRY MAYO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PENARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-962-2043
Mailing Address - Street 1:23929 MCBEAN PKWY # 100B
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:619-962-2043
Mailing Address - Fax:661-705-1336
Practice Address - Street 1:23929 MCBEAN PKWY # 100B
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-705-1330
Practice Address - Fax:661-705-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154252OtherPK