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Organization
WELLPATHRX INC
Active
Organization
WELLPATHRX INC
Active
Other names
Park Mesa Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CHERIAN (OWNER/PRESIDENT/PIC/AO)
(714) 319-4653
Entity
Organization
Contact information
Practice address
4314 W SLAUSON AVE, SUITE 1, LOS ANGELES, CA 90043-2808
(323) 378-3323
(323) 378-3324
Mailing address
4314 W SLAUSON AVE, SUITE 1, LOS ANGELES, CA 90043-2808
(323) 378-3323
(323) 378-3324
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
55987
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175520
PK
—
Enumeration date
02/07/2018
Last updated
07/27/2018
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