MEDICARE: H K PHARMACY CORP

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHY50201	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2124674	OTHER		PK

General Provider Information

NPI Number	:	1972666501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H K PHARMACY CORP

Provider Business Mailing Address
First Line	:	124 N WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4106
Country	:	US
Telephone Number	:	323-464-3925
Fax Number	:	323-464-3220

Provider Business Practice Location Address
First Line	:	124 N WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4106
Country	:	US
Telephone Number	:	323-464-3925
Fax Number	:	323-464-3220

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUSAN YOO
Credential	:
Telephone Number	:	323-464-3925

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	04/25/2017

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