Healthcare Provider Details

I. General information

NPI: 1255342838
Provider Name (Legal Business Name): CHJ PHARMACARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12841 WESTERN AVE STE D
GARDEN GROVE CA
92841-4025
US

IV. Provider business mailing address

12841 WESTERN AVE UNIT # D
GARDEN GROVE CA
92841-4025
US

V. Phone/Fax

Practice location:
  • Phone: 714-379-3080
  • Fax: 714-379-3082
Mailing address:
  • Phone: 714-379-3080
  • Fax: 714-379-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY45334
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WEBER
Title or Position: PRESIDENT
Credential:
Phone: 714-379-3080