Organization
GREAT POTTER CORP
Active
Other names
Soul and Body Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JACKY KAMEL RPH (CEO)
(760) 880-7546
Entity
Organization
Contact information
Practice address
82013 DR CARREON BLVD STE I, INDIO, CA 92201-5832
(442) 215-5785
(442) 215-5870
Mailing address
35782 RAPHAEL DR, PALM DESERT, CA 92211-4506
(760) 880-7546
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Enumeration date
01/19/2024
Last updated
01/24/2026
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