Organization
MOJAVE PHARMACY INC
Active
Other names
MOJAVE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TAN DO (OWNER)
(661) 824-1800
Entity
Organization
Contact information
Practice address
16912 HIGHWAY 14, MOJAVE, CA 93501-1226
(661) 824-1800
(661) 824-1802
Mailing address
16912 HIGHWAY 14, MOJAVE, CA 93501-1226
(661) 824-1800
(661) 824-1802
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47150
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113555
PK
—
05
—
PHA471500
—
CA
Enumeration date
12/11/2006
Last updated
07/19/2013
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