Provider Demographics
NPI:1154764769
Name:WELCARE PHARMACY, INC.
Entity type:Organization
Organization Name:WELCARE PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:PHUONG-CHI
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:760-687-5315
Mailing Address - Street 1:1921 W SAN MARCOS BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-3906
Mailing Address - Country:US
Mailing Address - Phone:760-727-3333
Mailing Address - Fax:760-727-3335
Practice Address - Street 1:1921 W SAN MARCOS BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-3906
Practice Address - Country:US
Practice Address - Phone:760-727-3333
Practice Address - Fax:760-727-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51182183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1154764769Medicaid