Provider Demographics
NPI:1801914056
Name:NEW-1 PHARMACY
Entity type:Organization
Organization Name:NEW-1 PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YUEH CHEAU
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:CHANGCHIEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:626-307-5517
Mailing Address - Street 1:808 E VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3607
Mailing Address - Country:US
Mailing Address - Phone:626-307-5517
Mailing Address - Fax:626-307-0893
Practice Address - Street 1:808 E VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3607
Practice Address - Country:US
Practice Address - Phone:626-307-5517
Practice Address - Fax:626-307-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY415113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1801914056Medicaid
CA5555140001Medicare NSC