Organization
KOAM PHARMACY INC
Active
Other names
KOAM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KWANG KIM RPH (OWNER / PHARMACIST)
(562) 402-3636
Entity
Organization
Contact information
Practice address
18102 PIONEER BLVD, STE 101, ARTESIA, CA 90701-3953
(562) 402-3636
(562) 402-3676
Mailing address
18102 PIONEER BLVD, STE 101, ARTESIA, CA 90701-3953
(562) 402-3636
(562) 402-3676
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY43380
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997467
PK
—
05
—
PHY433800
—
CA
Enumeration date
11/13/2006
Last updated
02/20/2017
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