MEDICARE: ECONO PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1912610106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECONO PHARMACY INC

Provider Business Mailing Address
First Line	:	15435 S WESTERN AVE
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90249-4323
Country	:	US
Telephone Number	:	714-423-0632
Fax Number	:

Provider Business Practice Location Address
First Line	:	15435 S WESTERN AVE
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90249-4323
Country	:	US
Telephone Number	:	714-423-0632
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST-IN-CHARGE
Name	:	JINHEE MOON SUH
Credential	:	PHARMD
Telephone Number	:	714-423-0632

Provider Enumeration Date	:	01/03/2023
Last Update Date	:	09/11/2024

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Directions to “ECONO PHARMACY INC ” Practice Location

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