Organization
CLOVER CARE PHARMACY INC
Active
Other names
CLOVER CARE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANG J. LEE (PRESIDENT/PIC)
(213) 384-8763
Entity
Organization
Contact information
Practice address
266 S HARVARD BLVD STE 140, LOS ANGELES, CA 90004-4389
(213) 384-8763
(213) 384-7521
Mailing address
266 S HARVARD BLVD STE 140, LOS ANGELES, CA 90004-4389
(213) 384-8763
(213) 384-7521
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57713
BOARD OF PHARMACY PERMIT
CA
Enumeration date
04/16/2020
Last updated
04/21/2020
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