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General NPI Number Information
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NPI Number | 1467598722
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Entity Type | Organization
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Legal Business Name | WELLNESS PHARMACY INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 10410 LOWER AZUSA RD
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City | EL MONTE
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State | CA
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Zip | 91731-1277
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Country | US
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Telephone | 626-448-7659
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Fax | 626-443-8253
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Provider Business Mailing Address
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Address Line | 10410 LOWER AZUSA RD
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City | EL MONTE
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State | CA
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Zip | 91731-1277
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Country | US
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Telephone | 626-448-7659
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Fax | 626-443-8253
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. YOUNG KYUNG CHO
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Credential | RPH
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Telephone | 626-448-7659
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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 46076
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License Number State | CA
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