=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184769853
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WELCOME PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2007
-----------------------------------------------------
Last Update Date | 12/22/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18379 PIONEER BLVD
-----------------------------------------------------
City | ARTESIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90701-5532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-860-6336
-----------------------------------------------------
Fax | 562-860-3345
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18379 PIONEER BLVD
-----------------------------------------------------
City | ARTESIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90701-5532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-860-6336
-----------------------------------------------------
Fax | 562-860-3345
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | KOWEN LEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 562-860-6336
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY45825
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------