Provider Demographics
NPI:1699447268
Name:BOLSA CARE PHARMACY INC
Entity type:Organization
Organization Name:BOLSA CARE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/SEC/CFO/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CUONG
Authorized Official - Middle Name:Q
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:408-394-4835
Mailing Address - Street 1:9550 BOLSA AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5944
Mailing Address - Country:US
Mailing Address - Phone:714-884-4742
Mailing Address - Fax:714-884-4755
Practice Address - Street 1:9550 BOLSA AVE STE 109
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5944
Practice Address - Country:US
Practice Address - Phone:714-884-4742
Practice Address - Fax:714-884-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy