Provider Demographics
NPI:1467467217
Name:OCEAN VIEW PHARMACY INC
Entity Type:Organization
Organization Name:OCEAN VIEW PHARMACY INC
Other - Org Name:10TH STREET MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROZITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMTOUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-394-5405
Mailing Address - Street 1:1450 10TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2857
Mailing Address - Country:US
Mailing Address - Phone:310-394-5405
Mailing Address - Fax:310-394-5408
Practice Address - Street 1:1450 10TH ST
Practice Address - Street 2:STE 100
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2857
Practice Address - Country:US
Practice Address - Phone:310-394-5405
Practice Address - Fax:310-394-5408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY489563336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2003035OtherPK
CAPHA228950Medicaid