Healthcare Provider Details

I. General information

NPI: 1316799109
Provider Name (Legal Business Name): WELLCOME PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 EL PASEO DE SARATOGA
SAN JOSE CA
95130-1633
US

IV. Provider business mailing address

1440 EL PASEO DE SARATOGA
SAN JOSE CA
95130-1633
US

V. Phone/Fax

Practice location:
  • Phone: 408-357-4184
  • Fax:
Mailing address:
  • Phone: 408-680-8400
  • Fax: 408-683-9268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHAU ONG
Title or Position: CEO
Credential: PHARM.D.
Phone: 408-357-4184