Quali-Care Health Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY49113 Issued in CA

Legal business name

QUALI-CARE HEALTH CORPORATION

Practice address

3737 Martin Luther King Jr Blvd
Suite 101
Lynwood, CA 90262-3513

Phone

(310) 537-1440

NPI assigned

Oct 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Khanh Horne

Title

President

Phone

(310) 537-1440

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CENTURYWOOD MEDICAL PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Annie Chacko

  • Pharmacist
  • Lynwood, CA
  • NPI 1376881797
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1295818342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910210368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 101",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-537-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALI-CARE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "KHANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-537-1440",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295818342",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0572342",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTURYWOOD MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Lynwood, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.