Healthcare Provider Details

I. General information

NPI: 1578559878
Provider Name (Legal Business Name): JMC DRUG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5634 N FIGUEROA ST
LOS ANGELES CA
90042-4102
US

IV. Provider business mailing address

5634 N FIGUEROA ST
LOS ANGELES CA
90042-4102
US

V. Phone/Fax

Practice location:
  • Phone: 323-254-2851
  • Fax: 323-254-0875
Mailing address:
  • Phone: 323-254-2851
  • Fax: 323-254-0875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY30779
License Number StateCA

VIII. Authorized Official

Name: JIMMY CHEUNG
Title or Position: OWNER
Credential:
Phone: 323-254-2851