Organization
LIVE WELL PHARMACY LLC
Active
Other names
LIVE WELL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN LUU RPH (OWNER/PIC/PHCY MGR)
(215) 437-9255
Entity
Organization
Contact information
Practice address
2453 GRANT AVE, PHILADELPHIA, PA 19114-1004
(215) 437-9255
(215) 941-7910
Mailing address
2453 GRANT AVE, PHILADELPHIA, PA 19114-1004
(215) 437-9255
(215) 941-7910
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482041
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024829300001
—
PA
01
—
2125849
PK
—
Enumeration date
07/16/2010
Last updated
05/06/2014
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