Organization
ELONG PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUI CUI (CEO/PIC)
(949) 988-3998
Entity
Organization
Contact information
Practice address
15415 JEFFREY RD STE 108, IRVINE, CA 92618-4103
(949) 988-3998
(949) 988-3996
Mailing address
15415 JEFFREY RD STE 108, IRVINE, CA 92618-4103
(949) 988-3998
(949) 988-3996
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
55621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55621
RETAIL PHARMACY LICENSE
CA
Enumeration date
09/20/2017
Last updated
07/21/2022
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