Organization
QUALI-CARE HEALTH CORPORATION
Active
Other names
CENTURYWOOD MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KHANH HORNE (PRESIDENT)
(310) 537-1440
Entity
Organization
Contact information
Practice address
3737 MARTIN LUTHER KING JR BLVD, SUITE 101, LYNWOOD, CA 90262-3513
(310) 537-1440
Mailing address
PO BOX 368, MONTROSE, CA 91021-0368
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY49113
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0572342
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
1295818342
—
CA
Enumeration date
10/23/2006
Last updated
11/04/2010
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