Provider Demographics
NPI:1598862336
Name:MC PHARMACY INC
Entity Type:Organization
Organization Name:MC PHARMACY INC
Other - Org Name:TODAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-438-2031
Mailing Address - Street 1:2200 E ANAHEIM ST
Mailing Address - Street 2:STE C
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3417
Mailing Address - Country:US
Mailing Address - Phone:562-438-2031
Mailing Address - Fax:562-438-1457
Practice Address - Street 1:2200 E ANAHEIM ST
Practice Address - Street 2:STE C
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3417
Practice Address - Country:US
Practice Address - Phone:562-438-2031
Practice Address - Fax:562-438-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY475503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA464140Medicaid
2112148OtherPK
2112148OtherPK