Active NPI
Be Well Pharmacy Inc
- Community/Retail Pharmacy
- Fullerton, CA
National Provider Identifier
1407302243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY54411
- Legal business name
- BE WELL PHARMACY INC
- Practice address
- 105 N Lawrence Ave
Fullerton, CA 92832 - Phone
- (714) 449-9300
- Fax
- (714) 449-9355
- NPI assigned
- Aug 31, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lilian Lee
- Title
- Pic/Owner
- Phone
- (714) 449-9300
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PHY54411 | CA | Primary |
Addresses
Primary practice location
105 N Lawrence Ave
Fullerton, CA 92832
Mailing address
105 N Lawrence Ave
Fullerton, CA 92832
Phone (714) 449-9300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHY 54411 | Other | CA | CALIFORNIA STATE BOARD OF PHARMACY PERMIT |
Other names 1
- Be Well Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170920000904 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 3779857321 | Practice locations: Fullerton, CA |
| O20230905001900 | CA | DME Supplier - Pharmacy | 3779857321 | Practice locations: Fullerton, CA |
National Provider Directory
National Provider Directory- Tax ID family
- Be Well Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Fullerton, CA
- NPI 1346004942
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Fullerton, CA
- NPI 1629510698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708041600000",
"number": "1407302243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N LAWRENCE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "92832",
"telephone_number": "714-449-9300",
"fax_number": "714-449-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N LAWRENCE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "92832",
"telephone_number": "714-449-9300",
"fax_number": "714-449-9355"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BE WELL PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-31",
"last_updated": "2024-02-16",
"certification_date": "2024-02-16",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "LILIAN",
"authorized_official_title_or_position": "PIC/OWNER",
"authorized_official_telephone_number": "714-449-9300"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY54411",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA STATE BOARD OF PHARMACY PERMIT",
"identifier": "PHY 54411",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Be Well Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.