Grand Ave Pharmacy

LBN: Soon R. Chung
Grand Ave Pharmacy is an health care organization with primary practice located at 1400 S Grand Ave #100, Los Angeles CA 90015-3048. The organization recently has only one registered license in Suppliers / Pharmacy, which is considered as the primary health care specialty. Soon R. Chung can be contacted via phone (213) 746-4114, or through Chung, Soon R via phone (213) 746-4114.

Contact Information

Primary practice address
1400 S Grand Ave #100 Los Angeles CA 90015-3048
Phone: (213) 746-4114
Fax: (213) 746-4465
Website:
Map and Directions
Authorized official contact:
Name: Chung, Soon R R.PH
Phone: (213) 746-4114

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PHY46585 California

Profile Details

NPI number 1437142981
LBN Legal business name Soon R. Chung
DBA Doing business as Grand Ave Pharmacy
Authorized official Chung, Soon R R.PH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437142981 NPPES
Other 5615971 NCPDP
MEDICAID PHA465850 NCPDP

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