Provider Demographics
NPI:1932795374
Name:CMC ENTERPRISE INC
Entity Type:Organization
Organization Name:CMC ENTERPRISE INC
Other - Org Name:ECHO RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:K
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:213-378-0122
Mailing Address - Street 1:2426 W 8TH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3840
Mailing Address - Country:US
Mailing Address - Phone:213-378-0122
Mailing Address - Fax:213-699-0711
Practice Address - Street 1:2426 W 8TH ST STE 112
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3840
Practice Address - Country:US
Practice Address - Phone:213-378-0122
Practice Address - Fax:213-699-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-20
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA57661Medicaid