Organization
OLYMPIC GERHART PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAE C SUH RPH (PRESIDENT/ PHARMACIST IN CHARGE)
(323) 722-1515
Entity
Organization
Contact information
Practice address
5724 E OLYMPIC BLVD, COMMERCE, CA 90022-5120
(323) 722-1515
(323) 722-2083
Mailing address
5724 E OLYMPIC BLVD, COMMERCE, CA 90022-5120
(323) 722-1515
(323) 722-2083
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
PHY53845
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53845
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-98625
NCPDP PROVIDER
CA
05
—
PHA468320
—
CA
01
—
PHY 53845
STATE BOARD OF PHARMACY
CA
Enumeration date
09/26/2006
Last updated
04/21/2017
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