Provider Demographics
NPI:1558783738
Name:ALLCARE PHARMACY, INC
Entity Type:Organization
Organization Name:ALLCARE PHARMACY, INC
Other - Org Name:ALLCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:Q
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:626-200-8511
Mailing Address - Street 1:11028 LOWER AZUSA RD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-1440
Mailing Address - Country:US
Mailing Address - Phone:626-442-8135
Mailing Address - Fax:626-442-8602
Practice Address - Street 1:11028 LOWER AZUSA RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-1440
Practice Address - Country:US
Practice Address - Phone:626-442-8135
Practice Address - Fax:626-442-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATBA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7088750001Medicare NSC