# TED'S VILLAGE PHARMACY INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922833730
- **Authorized official:** NGUYEN PHAM (PHARMACIST)
- **Authorized official phone:** (650) 349-1373

## Contact information

- **Practice address:** 29 W 25TH AVE, SAN MATEO, CA 94403-2236
- **Practice address phone:** (650) 349-1373
- **Practice address fax:** (650) 349-1745
- **Mailing address:** 29 W 25TH AVE, SAN MATEO, CA 94403-2236
- **Mailing address phone:** (650) 349-1373
- **Mailing address fax:** (650) 349-1745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/03/2024
- **Last updated:** 09/03/2024