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General NPI Number Information
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NPI Number | 1811248792
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Entity Type | Organization
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Legal Business Name | P & K PHARMACY, INC
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 55 E CALIFORNIA BLVD SUITE 103
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City | PASADENA
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State | CA
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Zip | 91105-3954
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Country | US
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Telephone | 626-795-5956
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Fax | 626-795-4998
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Provider Business Mailing Address
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Address Line | 55 E CALIFORNIA BLVD SUITE 103
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City | PASADENA
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State | CA
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Zip | 91105-3954
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Country | US
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Telephone | 626-795-5956
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Fax | 626-795-4998
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Authorized Official
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Title or Position | CEO
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Name | DR. MINAH KIM
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Credential | PHARM. D.
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Telephone | 626-795-5956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH56164
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License Number State | CA
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