Healthcare Provider Details

I. General information

NPI: 1366425233
Provider Name (Legal Business Name): WELLNESS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 EASTERN AVE STE C
BELL GARDENS CA
90201-4515
US

IV. Provider business mailing address

7625 EASTERN AVE STE C
BELL GARDENS CA
90201-4515
US

V. Phone/Fax

Practice location:
  • Phone: 323-773-3800
  • Fax: 562-928-6275
Mailing address:
  • Phone: 323-773-3785
  • Fax: 562-928-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number49170
License Number StateCA

VIII. Authorized Official

Name: YOUNG CHO
Title or Position: PRESIDENT
Credential:
Phone: 626-318-3949