Provider Demographics
NPI:1023010725
Name:KING PHARMACY CORPORATION
Entity Type:Organization
Organization Name:KING PHARMACY CORPORATION
Other - Org Name:KING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:UDING
Authorized Official - Middle Name:
Authorized Official - Last Name:YULINTA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:323-262-8845
Mailing Address - Street 1:2707 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-1441
Mailing Address - Country:US
Mailing Address - Phone:323-262-8845
Mailing Address - Fax:323-262-8841
Practice Address - Street 1:2707 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-1441
Practice Address - Country:US
Practice Address - Phone:323-262-8845
Practice Address - Fax:323-262-8841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY45679333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0578510OtherNABP
CAPHA456790Medicaid
CAPHA456790Medicaid