Organization
LUCKY HEALTH INC
Active
Other names
LUCKY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHIU FONG YAN PHARMACIST (PRESIDENT/PIC)
(626) 447-3888
Entity
Organization
Contact information
Practice address
1108 S BALDWIN AVE, STORE NUMBER 8 & 9, ARCADIA, CA 91007-7508
(626) 447-3888
(626) 869-1802
Mailing address
1108 S BALDWIN AVE, STORE NUMBER 8 & 9, ARCADIA, CA 91007-7508
(626) 447-3888
(626) 869-1802
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 52063
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-12675
NCPDP NUMBER
CA
01
—
PHY 52063
BOARD OF PHARMACY PERMIT
CA
Enumeration date
08/10/2006
Last updated
09/10/2014
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