Organization Active NPI

Be Well Pharmacy Inc

  • Community/Retail Pharmacy
  • Fullerton, CA
National Provider Identifier
1407302243
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY54411 Issued in CA
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

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Lilian LeeNPI 1629510698
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PHY 54411OtherCACALIFORNIA STATE BOARD OF PHARMACY PERMIT

Other names 1

  • Be Well Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

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.

Verify at the official NPI Registry.