Provider Demographics
NPI:1144574260
Name:MEDPILOT PHARMACY INC.
Entity Type:Organization
Organization Name:MEDPILOT PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JACKY
Authorized Official - Middle Name:LUNG HING
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MBA
Authorized Official - Phone:858-229-9282
Mailing Address - Street 1:11790 PAPAGALLO CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2802
Mailing Address - Country:US
Mailing Address - Phone:858-229-9282
Mailing Address - Fax:
Practice Address - Street 1:9323 CHESAPEAKE DR
Practice Address - Street 2:SUITE #C1
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1044
Practice Address - Country:US
Practice Address - Phone:858-278-7500
Practice Address - Fax:858-278-7501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51917333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy