Provider Demographics
NPI:1649405358
Name:KACHIS PHARMACY INC
Entity Type:Organization
Organization Name:KACHIS PHARMACY INC
Other - Org Name:JUELLE & LIMA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGALI
Authorized Official - Middle Name:L
Authorized Official - Last Name:JUELLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:323-562-1577
Mailing Address - Street 1:4566 FLORENCE AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-4345
Mailing Address - Country:US
Mailing Address - Phone:323-562-1577
Mailing Address - Fax:323-773-5140
Practice Address - Street 1:4566 E. FLORENCE AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:CUDAHY
Practice Address - State:CA
Practice Address - Zip Code:90201-4347
Practice Address - Country:US
Practice Address - Phone:323-562-1577
Practice Address - Fax:323-773-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY30262333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA302620Medicaid
CA6237370001Medicare NSC