St. Mary Medical Group, LLC
NPI #1477760379 in Idyllwild, California
Provider Information
- NPI Number
- 1477760379
- Entity Type
- Organization
- Organization Name
- St. Mary Medical Group, LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- May 17, 2007
- Last Updated
- Dec 26, 2018
Practice Location
- Address
- 54391 VILLAGE CENTER DR # 6
- City
- Idyllwild
- State
- California
- ZIP Code
- 92549-9997
- Phone
- (951) 659-2135
Authorized Official
- Name
- MR. JAMES MARIO LA PONZA, PHARM.D
- Title
- VICE PRESIDENT/PHARMACIST-IN-CHARGE
- Phone
- (951) 659-2135
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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