Provider Demographics
NPI:1316799109
Name:WELLCOME PHARMACY, INC.
Entity type:Organization
Organization Name:WELLCOME PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAU
Authorized Official - Middle Name:
Authorized Official - Last Name:ONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:408-357-4184
Mailing Address - Street 1:1440 EL PASEO DE SARATOGA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1633
Mailing Address - Country:US
Mailing Address - Phone:408-680-8400
Mailing Address - Fax:408-683-9268
Practice Address - Street 1:1440 EL PASEO DE SARATOGA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95130-1633
Practice Address - Country:US
Practice Address - Phone:408-357-4184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy