Provider Demographics
NPI:1639184252
Name:WHITTIER COMMUNITY PHARMACY INC
Entity Type:Organization
Organization Name:WHITTIER COMMUNITY PHARMACY INC
Other - Org Name:WHITTIER COMM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHARMCIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:562-945-2325
Mailing Address - Street 1:8135 PAINTER AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3158
Mailing Address - Country:US
Mailing Address - Phone:562-945-2325
Mailing Address - Fax:562-698-3207
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:STE 100
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3158
Practice Address - Country:US
Practice Address - Phone:562-945-2325
Practice Address - Fax:562-698-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY378563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA378560Medicaid
0589551OtherNCPDP PROVIDER IDENTIFICATION NUMBER