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Organization

GRACE WANG

Active
Other names
MEDICINE SHOPPE
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE WANG RPH (OWNER PHARMACIST)
(805) 375-6650
Entity
Organization

Contact information

Practice address
2241 MICHAEL DR, NEWBURY PARK, CA 91320-3340
(805) 375-6650
(805) 375-6654
Mailing address
2241 MICHAEL DR, NEWBURY PARK, CA 91320-3340

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY41868
CA
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0544836
OTHER ID NUMBER-COMMERCIAL NUMBER
05
PHY418680
CA
Enumeration date
12/26/2006
Last updated
03/07/2023
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