=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053959189
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHARMMED INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2019
-----------------------------------------------------
Last Update Date | 12/19/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 360 E LAS TUNAS DR STE 101A
-----------------------------------------------------
City | SAN GABRIEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91776-5514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-656-6955
-----------------------------------------------------
Fax | 626-656-6956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 360 E LAS TUNAS DR STE 101A
-----------------------------------------------------
City | SAN GABRIEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91776-5514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-656-6955
-----------------------------------------------------
Fax | 626-656-6956
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PIC/OWNER
-----------------------------------------------------
Name | YUCO YUE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-656-6955
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------