Healthcare Provider Details

I. General information

NPI: 1366263642
Provider Name (Legal Business Name): QTK HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9008 GARVEY AVE STE A
ROSEMEAD CA
91770-3370
US

IV. Provider business mailing address

9008 GARVEY AVE STE A
ROSEMEAD CA
91770-3370
US

V. Phone/Fax

Practice location:
  • Phone: 626-427-1302
  • Fax: 626-469-5740
Mailing address:
  • Phone: 626-427-1302
  • Fax: 626-469-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. QUANG K THAI
Title or Position: PHARMACIST
Credential: PHARM. D.
Phone: 626-456-3862