Organization
INNOVA PHARMACY IV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM THIEN LE PHARM.D. (CEO)
(916) 220-3344
Entity
Organization
Contact information
Practice address
4815 WATT AVE STE B101, NORTH HIGHLANDS, CA 95660-5108
(916) 220-3344
Mailing address
2400 GLENDALE LN STE A, SACRAMENTO, CA 95825-2431
(916) 487-9977
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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