Provider Demographics
NPI:1053450908
Name:WELLTECH NETWORK INC
Entity Type:Organization
Organization Name:WELLTECH NETWORK INC
Other - Org Name:A PLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOSHIO
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-821-7788
Mailing Address - Street 1:6888 LINCOLN AVE
Mailing Address - Street 2:STE J
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6888 LINCOLN AVE
Practice Address - Street 2:STE J
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4107
Practice Address - Country:US
Practice Address - Phone:714-821-7788
Practice Address - Fax:714-821-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY420033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA420030Medicaid
0568937OtherOTHER ID NUMBER