Provider Demographics
NPI:1033213087
Name:GOOD PRICE CORPORATION
Entity Type:Organization
Organization Name:GOOD PRICE CORPORATION
Other - Org Name:GOOD PRICE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-255-5161
Mailing Address - Street 1:6000 N FIGUEROA ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4232
Mailing Address - Country:US
Mailing Address - Phone:323-255-5161
Mailing Address - Fax:323-255-5136
Practice Address - Street 1:6000 N FIGUEROA ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4232
Practice Address - Country:US
Practice Address - Phone:323-255-5161
Practice Address - Fax:323-255-5136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY449693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033213087Medicaid
0537475OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0537475OtherNCPDP PROVIDER IDENTIFICATION NUMBER