Organization
RIVERSIDE PHARMACY & COMPOUNDING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY NHUNG TUYET LUU PHARMD (PHARMACIST IN CHARGE)
(951) 343-1633
Entity
Organization
Contact information
Practice address
9448 MAGNOLIA AVE, SUITE B, RIVERSIDE, CA 92503
(951) 343-1633
(951) 343-1675
Mailing address
9448 MAGNOLIA AVE, SUITE B, RIVERSIDE, CA 92503
(951) 343-1633
(951) 343-1675
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615060
NABP
—
05
—
PHA467160
—
CA
Enumeration date
11/10/2006
Last updated
08/22/2020
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