Organization
JAMES A WILSON
Active
Other names
SIX TWELVE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WILSON PHRM (OWNER)
(626) 447-4572
Entity
Organization
Contact information
Practice address
107 W HUNTINGTON DR, STE A, ARCADIA, CA 91007-3026
(626) 446-4400
(626) 447-2320
Mailing address
107 W HUNTINGTON DR, STE A, ARCADIA, CA 91007-3026
(626) 446-4400
(626) 446-2320
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY36222
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2028484
PK
—
Enumeration date
10/25/2006
Last updated
06/25/2013
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