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KOAM PHARMACY LTC INC NPI 1033678248


NPI Information

NPI: 1033678248
Provider Name: KOAM PHARMACY LTC INC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
18102 PIONEER BLVD STE 102
ARTESIA, CA
ZIP 90701
Phone: (562) 402-0400
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KOAM PHARMACY LTC INC is a long term care pharmacy pharmacy in Artesia, CA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. KOAM PHARMACY LTC INC NPI is 1033678248. The provider is registered as an organization entity type.

The provider's business location address is:

18102 PIONEER BLVD STE 102
ARTESIA, CA
ZIP 90701-400
Phone: (562) 402-0400

The provider's authorized official is Kwang Ja Kim .
The authorized official title is Ceo and has the following contact phone number (562) 402-4922.

The enumeration date for this NPI number is 3/18/2019 and was last updated on 11/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251G00000XHospice Care, Community BasedNo
23336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11033678248MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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