Provider Demographics
NPI:1922545342
Name:WELLCOME PHARMACY GROUP INC
Entity type:Organization
Organization Name:WELLCOME PHARMACY GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNGTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:626-766-1799
Mailing Address - Street 1:828 E VALLEY BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3699
Mailing Address - Country:US
Mailing Address - Phone:626-766-1799
Mailing Address - Fax:626-766-1790
Practice Address - Street 1:828 E VALLEY BLVD
Practice Address - Street 2:STE B
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3699
Practice Address - Country:US
Practice Address - Phone:626-766-1799
Practice Address - Fax:626-766-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy