Live Well Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482041 Issued in PA

Legal business name

LIVE WELL PHARMACY LLC

Doing business as

LIVE WELL PHARMACY

Practice address

2453 Grant Ave
Philadelphia, PA 19114-1004

Phone

(215) 437-9255

Fax

(215) 941-7910

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Karen Luu, RPH

Title

Owner/Pic/Phcy MGR

Phone

(215) 437-9255

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• LIVE WELL PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1306159579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2453 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141004",
            "telephone_number": "215-437-9255",
            "fax_number": "215-941-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2453 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141004",
            "telephone_number": "215-437-9255",
            "fax_number": "215-941-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "LUU",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER/PIC/PHCY MGR",
        "authorized_official_telephone_number": "215-437-9255",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024829300001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125849",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVE WELL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.