Provider Demographics
NPI:1952100869
Name:PACIFIC PHARMACY INC.
Entity type:Organization
Organization Name:PACIFIC PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:UNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-281-6800
Mailing Address - Street 1:207 S SANTA ANITA ST STE G10
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1147
Mailing Address - Country:US
Mailing Address - Phone:626-281-6800
Mailing Address - Fax:626-281-6696
Practice Address - Street 1:207 S SANTA ANITA ST STE G10
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1147
Practice Address - Country:US
Practice Address - Phone:626-281-6800
Practice Address - Fax:626-281-6696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy