Organization
LA BUENA VIDA PHARMACY INC
Active
Other names
LA BUENA VIDA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMONE AOY YEE YIK PHARM D (PRESIDENT/PIC)
(760) 398-8866
Entity
Organization
Contact information
Practice address
51-335 CESAR CHAVEZ ST, SUITE 116, COACHELLA, CA 92236-1547
(760) 398-8866
(760) 398-9966
Mailing address
51-335 CESAR CHAVEZ ST, SUITE 116, COACHELLA, CA 92236-1547
(760) 398-8866
(760) 398-9966
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY51158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-45518
NCPDP
—
01
—
GY413A
MEDICARE PART B
—
Enumeration date
09/12/2012
Last updated
08/22/2018
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