Provider Demographics
NPI:1770646309
Name:ZOEY PHARMACY INC
Entity Type:Organization
Organization Name:ZOEY PHARMACY INC
Other - Org Name:ZOEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BING
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-298-5858
Mailing Address - Street 1:18500 VIA PRINCESSA
Mailing Address - Street 2:STE 4
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-8321
Mailing Address - Country:US
Mailing Address - Phone:661-298-5858
Mailing Address - Fax:661-298-5880
Practice Address - Street 1:18500 VIA PRINCESSA
Practice Address - Street 2:STE 4
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91387-8321
Practice Address - Country:US
Practice Address - Phone:661-298-5858
Practice Address - Fax:661-298-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY470503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2113453OtherPK
CAPHA470500Medicaid
2113453OtherPK