Organization
GREAT COMPANY
Active
Other names
986 Pharmacy #8032
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA XU PHARM D. (CEO)
(626) 791-7595
Entity
Organization
Contact information
Practice address
2554 E WASHINGTON BLVD, STE B, PASADENA, CA 91107-1445
(626) 791-7595
(626) 791-3564
Mailing address
2554 E WASHINGTON BLVD, STE B, PASADENA, CA 91107-1445
(626) 791-7595
(626) 791-3564
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59569
BOARD OF PHARMACY
CA
Enumeration date
03/02/2007
Last updated
09/26/2024
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