Organization
VAN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VAN THI HONG DANG RPH (PHARMACIST IN CHARGE OWNER)
(209) 478-9868
Entity
Organization
Contact information
Practice address
4502 N PERSHING AVE, #AB, STOCKTON, CA 95207
(209) 478-9868
(209) 478-6930
Mailing address
4502 N PERSHING AVE, #AB, STOCKTON, CA 95207
(209) 478-9868
(209) 478-6930
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY41834
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA418340
—
CA
01
—
PHY41834
PHARMACY
—
01
—
RPH43745
PHARMACIST
—
Enumeration date
10/20/2006
Last updated
02/14/2008
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