Provider Demographics
NPI:1861122061
Name:ENCOMPASS PHARMACY, INC
Entity type:Organization
Organization Name:ENCOMPASS PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-480-1503
Mailing Address - Street 1:1110 N WESTERN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1199
Mailing Address - Country:US
Mailing Address - Phone:323-465-3112
Mailing Address - Fax:323-465-2605
Practice Address - Street 1:1110 N WESTERN AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1199
Practice Address - Country:US
Practice Address - Phone:323-465-3112
Practice Address - Fax:323-465-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy