Organization
ABSOLUTE WELLCARE LLC
Active
Other names
Absolute Wellcare LLc
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE KUPPERMANN (OWNER)
(818) 779-8648
Entity
Organization
Contact information
Practice address
15800 ARMINTA ST, VAN NUYS, CA 91406-1918
(818) 779-8648
(818) 779-8672
Mailing address
15800 ARMINTA ST, VAN NUYS, CA 91406-1918
(818) 779-8648
(818) 779-8672
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
59029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5643742
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/16/2012
Last updated
03/29/2013
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