Provider Demographics
NPI:1750454815
Name:TOMS PHARMACY
Entity Type:Organization
Organization Name:TOMS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMICIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:JONAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:626-331-0721
Mailing Address - Street 1:2686 E GARVEY AVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791
Mailing Address - Country:US
Mailing Address - Phone:626-331-0721
Mailing Address - Fax:626-967-2321
Practice Address - Street 1:2686 E GARVEY AVE SOUTH
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791
Practice Address - Country:US
Practice Address - Phone:626-331-0721
Practice Address - Fax:626-967-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY440010Medicaid