Pediatric Care Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

BP3394397 Issued in CA

Legal business name

PEDIATRIC CARE PHARMACY INC

Practice address

4616 De Longpre Ave
Los Angeles, CA 90027-6076

Phone

(323) 913-5801

Fax

(323) 913-5820

NPI assigned

Jan 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas J Liautaud, RPH

Title

President

Phone

(213) 413-2343

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699755637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 DE LONGPRE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276076",
            "telephone_number": "213-413-2343",
            "fax_number": "323-913-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 DE LONGPRE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276076",
            "telephone_number": "323-913-5801",
            "fax_number": "323-913-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIAUTAUD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-413-2343",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "BP3394397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA376820",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0565905",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric and Family Medical Center (Eisner Health Student and Family Wellness Center)
• Pediatric and Family Medical Center (Eisner Pediatric and Family Medical Center)
• Pediatric and Family Medical Center (Eisner Pediatric and Family Medical Center)
• Pediatric and Family Medical Center (Eisner Health)
• Pediatric and Family Medical Center (Eisner Pediatric and Family Medical Center)
• Pediatric Gems, P.C.
• Pediatric Ophthalmology and Strabismus Specialists
• Pediatric Therapy Playhouse
• Tiffany Prugpichailers Pedigo, M.D.
• Nathaniel Mark Pedley, MD

• Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• 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.