Organization
GOODLIFE RX LLC
Active
Other names
GARCIA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THUY MIEN LE (MANAGING MEMBER)
(408) 294-3219
Entity
Organization
Contact information
Practice address
25 N 14TH STREET, STE 110, SAN JOSE, CA 95112-6208
(408) 294-3219
(408) 465-0832
Mailing address
25 N 14TH STREET, STE 110, SAN JOSE, CA 95112-6208
(408) 294-3219
(408) 465-0832
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-71424
NCPDP
CA
01
—
PHY57971
BOARD OF PHARMACY
CA
Enumeration date
07/11/2019
Last updated
09/23/2021
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