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Organization

MODERN DRUG INC

Active
Other names
Tous Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
KIMPHI THI LE RPH (PIC/TREASURER)
(559) 268-2547
Entity
Organization

Contact information

Practice address
3250 E OLIVE AVE, STE B, FRESNO, CA 93702-1023
(559) 268-2547
(559) 268-0212
Mailing address
3250 E OLIVE AVE, STE B, FRESNO, CA 93702-1023
(559) 268-2547
(559) 268-0212

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
PHY48897
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0547793
NCPDP
CA
05
1134128655
CA
Enumeration date
07/18/2005
Last updated
02/24/2011
About Stedi
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