Provider Demographics
NPI:1609903715
Name:HHSA PHARMACY
Entity Type:Organization
Organization Name:HHSA PHARMACY
Other - Org Name:SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACY TECHNICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCDONOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-692-8033
Mailing Address - Street 1:16914 TORBETT LN
Mailing Address - Street 2:#13
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-6803
Mailing Address - Country:US
Mailing Address - Phone:858-312-6642
Mailing Address - Fax:619-692-8034
Practice Address - Street 1:3851 ROSECRANS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3115
Practice Address - Country:US
Practice Address - Phone:858-692-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital