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General NPI Number Information
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NPI Number | 1023330073
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Entity Type | Organization
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Legal Business Name | BW ONE, INC.
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 655 N BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90012-2801
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Country | US
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Telephone | 626-617-7888
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Fax | 213-617-7887
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Provider Business Mailing Address
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Address Line | 655 N BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90012-2801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRIAN PAK WU
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Credential | PHARM.D.
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Telephone | 213-617-7888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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