Organization
GRAND PHARMACY., INC
Active
Organization
GRAND PHARMACY., INC
Active
Other names
Grand Pharmacy., Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JOON TAE CHOI (CEO)
(213) 380-5100
Entity
Organization
Contact information
Practice address
505 S VIRGIL AVE # 107, LOS ANGELES, CA 90020-1406
(213) 380-5100
(213) 380-5101
Mailing address
505 S VIRGIL AVE # 107, LOS ANGELES, CA 90020-1406
(213) 380-5100
(213) 380-5101
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
54623
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145807
PK
—
Enumeration date
05/19/2014
Last updated
09/09/2016
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