# CLOVER CARE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLOVER CARE PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164042453
- **Authorized official:** MRS. SANG J. LEE (PRESIDENT/PIC)
- **Authorized official phone:** (213) 384-8763

## Contact information

- **Practice address:** 266 S HARVARD BLVD STE 140, LOS ANGELES, CA 90004-4389
- **Practice address phone:** (213) 384-8763
- **Practice address fax:** (213) 384-7521
- **Mailing address:** 266 S HARVARD BLVD STE 140, LOS ANGELES, CA 90004-4389
- **Mailing address phone:** (213) 384-8763
- **Mailing address fax:** (213) 384-7521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/16/2020
- **Last updated:** 04/21/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 57713 | BOARD OF PHARMACY PERMIT | CA |