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Organization
986 PHARMACY 8001 INC
Active
Organization
986 PHARMACY 8001 INC
Active
Other names
986 Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA XU PHARMD (CEO)
(909) 596-6168
Entity
Organization
Contact information
Practice address
2143 FOOTHILL BLVD, LA VERNE, CA 91750-2942
(909) 596-6168
(909) 596-6155
Mailing address
2143 FOOTHILL BLVD, LA VERNE, CA 91750-2942
(909) 596-6168
(909) 596-6155
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
PHY53763
CA
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155502
PK
—
Enumeration date
11/20/2015
Last updated
07/15/2024
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