| NPI | 1912542275 |
|---|---|
| Doing Business As | 986 PHARMACY #8008 |
| Entity Type | Organization |
| Authorized Contact | GERALD KO Pharmacy Manager 323-707-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2021-01-12 |