Organization
ELK GROVE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN HOANG (PHARMACIST/OWNER)
(408) 239-9622
Entity
Organization
Contact information
Practice address
8470 ELK GROVE BLVD STE 150, ELK GROVE, CA 95758-5925
(408) 239-9622
(916) 896-5194
Mailing address
8470 ELK GROVE BLVD STE 150, ELK GROVE, CA 95758-5925
(916) 667-3852
(916) 896-5194
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
55264
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166808
PK
—
Enumeration date
12/01/2016
Last updated
03/21/2017
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