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General NPI Number Information
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NPI Number | 1861484214
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Entity Type | Organization
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Legal Business Name | QC PHARMACY CORP
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Dates
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Enumeration Date | 08/20/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 727 W SAN MARCOS BLVD STE 113
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City | SAN MARCOS
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State | CA
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Zip | 92078-1244
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Country | US
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Telephone | 760-744-5959
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Fax | 760-744-5960
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Provider Business Mailing Address
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Address Line | 727 W SAN MARCOS BLVD STE 113
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City | SAN MARCOS
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State | CA
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Zip | 92078-1244
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Country | US
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Telephone | 760-744-5959
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Fax | 760-744-5960
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Authorized Official
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Title or Position | PRESIDENT
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Name | HEEJIN KIM
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Credential | PHARMD
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Telephone | 617-640-4576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 39483
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY39483
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License Number State | CA
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