Friendly Hills Medical Center Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY44769 Issued in CA

Legal business name

FRIENDLY HILLS MEDICAL CENTER PHARMACY INC

Practice address

12675 La Mirada Blvd Ste 100
La Mirada, CA 90638-2249

Phone

(562) 777-8175

Fax

(562) 777-7156

NPI assigned

Feb 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Chris Wall, PHARM.D.

Title

Pharmacist in Charge

Phone

(562) 777-8175

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bright La Mirada Pharmacy Doing business as

Tax ID family

Bright la Mirada Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Friendly Hills Medical Center Pharmacy Inc

  • Community/Retail Pharmacy
  • Whittier, CA
  • NPI 1861551392
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Jared Wall, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • La Mirada, CA
  • NPI 1568173508
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053452227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12675 LA MIRADA BLVD STE 100",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382249",
            "telephone_number": "562-777-8175",
            "fax_number": "562-777-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12675 LA MIRADA BLVD STE 100",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382249",
            "telephone_number": "562-777-8175",
            "fax_number": "562-777-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDLY HILLS MEDICAL CENTER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "562-777-8175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY44769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA447690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright La Mirada Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marvin Forman, O.D.
• Myriam Forster, B.A.
• Cherie Cynthia Fort, FNP-BC
• Damian Paul Fowler, LMFT
• Melissa Fowler, LCSW
• Magdy W Gad, DDS
• Gregory John Galbreath, M.D.
• Gaminchi and Kim Dental Corporation
• Marisa Garcia, M.A., BCBA
• Terry Ann Garcia, LCSW

• Community/Retail Pharmacy in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.