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General NPI Number Information
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NPI Number | 1871986505
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Entity Type | Organization
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Legal Business Name | I & J PHARMACY LLC
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 11855 E SOUTH ST
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City | CERRITOS
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State | CA
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Zip | 90703-6825
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Country | US
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Telephone | 562-444-5545
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Fax | 562-444-5560
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Provider Business Mailing Address
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Address Line | 11855 E SOUTH ST
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City | CERRITOS
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State | CA
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Zip | 90703-6825
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Country | US
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Telephone | 562-444-5545
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Fax | 562-444-5560
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Authorized Official
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Title or Position | CEO
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Name | DR. JOHN PARK
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Credential | PHARM.D.
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Telephone | 562-547-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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