Provider Demographics
NPI:1881945889
Name:WU, ALICE (RPH)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3604
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-0604
Mailing Address - Country:US
Mailing Address - Phone:626-872-8622
Mailing Address - Fax:
Practice Address - Street 1:107 S LONG BEACH BLVD
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3423
Practice Address - Country:US
Practice Address - Phone:310-639-8026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist