=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154764769
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WELCARE PHARMACY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2013
-----------------------------------------------------
Last Update Date | 05/13/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1921 W SAN MARCOS BLVD SUITE 140
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92078-3906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-727-3333
-----------------------------------------------------
Fax | 760-727-3335
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1921 W SAN MARCOS BLVD SUITE 140
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92078-3906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-727-3333
-----------------------------------------------------
Fax | 760-727-3335
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CLAIRE PHUONG-CHI VO
-----------------------------------------------------
Credential | PHARM. D
-----------------------------------------------------
Telephone | 760-687-5315
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 51182
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------