Provider Demographics
NPI:1184707028
Name:MCCARTHY PHARMACY INC
Entity type:Organization
Organization Name:MCCARTHY PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MORDECHAI
Authorized Official - Middle Name:S
Authorized Official - Last Name:NIKFAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:310-452-1105
Mailing Address - Street 1:12025 SAN VICENTE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-4922
Mailing Address - Country:US
Mailing Address - Phone:310-452-1105
Mailing Address - Fax:310-452-5938
Practice Address - Street 1:12025 SAN VICENTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-4922
Practice Address - Country:US
Practice Address - Phone:310-452-1105
Practice Address - Fax:310-452-5938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0552047OtherNABP
CAPHA467010Medicaid
CA5121550001Medicare NSC