Provider Demographics
NPI:1992856587
Name:HK GALLERIA PHARMACY INC
Entity Type:Organization
Organization Name:HK GALLERIA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:UNMI
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:323-829-2548
Mailing Address - Street 1:3250 W. OLYMPIC BLVD. SUITE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006
Mailing Address - Country:US
Mailing Address - Phone:323-733-7200
Mailing Address - Fax:323-733-1137
Practice Address - Street 1:3250 W. OLYMPIC BLVD. SUITE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006
Practice Address - Country:US
Practice Address - Phone:323-733-7200
Practice Address - Fax:323-733-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY45320333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA453200Medicaid
CAPHA453200Medicaid