Misinko Inc

Organization Active NPI Community/Retail Pharmacy · Cudahy, CA

NPI 1114917358 · NPPES record last updated Feb 18, 2016

Key facts

NPI
1114917358
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHY43282 (CA)
Legal business name
MISINKO INC
Practice address
7611 Atlantic Ave
Cudahy, CA 90201-5019
Phone
(323) 773-1700
Fax
(323) 773-5959
NPI assigned
Oct 27, 2005
Organization subpart
No

Authorized official

Name
Pratish Mistry, RPH
Title
Treasurer
Phone
(323) 773-1700

Practitioners 1

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
St James Pharmacy
7611 Atlantic Ave, Cudahy, CA 90201-5019 · (323) 773-1700
Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignment
Participating since Jun 21, 2005

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930095975 CA DME Supplier - Pharmacy 9931300019 Practice locations: Cudahy, CA

National Provider Directory

Locations

7611 Atlantic Ave
Cudahy, CA 90201
Phone (323) 773-1700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY43282 CA Yes

Addresses

Primary practice location

7611 Atlantic Ave
Cudahy, CA 90201-5019

Mailing address

7611 Atlantic Ave
Cudahy, CA 90201-5019
Phone (323) 773-1700

Other identifiers

IdentifierTypeStateIssuer
2075229OtherPK
PHA432820MedicaidCA

Other names

  • ST JAMES PHARMACY Doing business as

Other providers in Cudahy, CA

All providers in Cudahy, CA · Community/Retail Pharmacy in California

Sources for this page

Verify at the official NPI Registry.