Organization
INNOVA PHARMACEUTICALS INC
Active
Other names
Innova Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM T. LE PHARM.D. (PRESIDENT/CEO)
(916) 481-6900
Entity
Organization
Contact information
Practice address
5830 JAMESON CT, CARMICHAEL, CA 95608-0896
(916) 481-6900
(916) 481-6680
Mailing address
5830 JAMESON CT, CARMICHAEL, CA 95608-0896
(916) 481-6900
(916) 481-6680
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0589703
OTHER ID NUMBER
—
05
—
1568529915
—
CA
Enumeration date
01/03/2007
Last updated
10/22/2021
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