Regent Square Pharmacy

LBN: 1631 Montana Ave Pharmacy, Llc
Regent Square Pharmacy is an health care organization with primary practice located at 1631 Montana Ave , Santa Monica CA 90403-1807. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. 1631 Montana Ave Pharmacy, Llc can be contacted via phone (310) 393-0761, or through Kong, Eleanor via phone (310) 393-0761.

Contact Information

Primary practice address
1631 Montana Ave Santa Monica CA 90403-1807
Phone: (310) 393-0761
Fax: (310) 395-6654
Website:
Map and Directions
Authorized official contact:
Name: Kong, Eleanor PHARMD
Phone: (310) 393-0761

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHY 49018 California

Profile Details

NPI number 1881600476
LBN Legal business name 1631 Montana Ave Pharmacy, Llc
DBA Doing business as Regent Square Pharmacy
Authorized official Kong, Eleanor PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2006
Last updated Apr 14th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881600476 NPPES
California MEDICAID PHA465390
California Other 05-73065

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