Provider Demographics
NPI:1194405035
Name:WHITTIER PHARMACY INC
Entity type:Organization
Organization Name:WHITTIER PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PIC
Authorized Official - Prefix:
Authorized Official - First Name:MINKYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-945-4166
Mailing Address - Street 1:12291 WASHINGTON BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2549
Mailing Address - Country:US
Mailing Address - Phone:562-945-4166
Mailing Address - Fax:
Practice Address - Street 1:12291 WASHINGTON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2549
Practice Address - Country:US
Practice Address - Phone:562-945-4166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy