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General NPI Number Information
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NPI Number | 1124455464
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Entity Type | Organization
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Legal Business Name | OLIVE HILL PHARMACY, INC.
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 255 S HILL ST # 217
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City | LOS ANGELES
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State | CA
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Zip | 90012-3500
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Country | US
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Telephone | 213-680-2000
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Fax | 213-680-2010
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Provider Business Mailing Address
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Address Line | 255 S HILL ST # 217
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City | LOS ANGELES
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State | CA
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Zip | 90012-3500
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Country | US
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Telephone | 213-680-2000
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Fax | 213-680-2010
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Authorized Official
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Title or Position | VICE PRESIDENT/PHARMACIST IN CHARGE
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Name | SUNG YEE KIM
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Credential | PHARM D
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Telephone | 213-680-2000
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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 | PHY 51614
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License Number State | CA
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