Organization
TILTON NGUYEN PHARMACEUTICAL INC
Active
Other names
Oasis Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE TILTON (PHARMACIST IN CHARGE)
(760) 241-4080
Entity
Organization
Contact information
Practice address
15433 W SAND ST STE 102, VICTORVILLE, CA 92392-2903
(760) 241-4080
(760) 241-4171
Mailing address
15433 W SAND ST STE 102, VICTORVILLE, CA 92392-2903
(760) 241-4080
(760) 241-4171
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
53859
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720328453
—
CA
01
—
2138994
PK
—
Enumeration date
02/16/2013
Last updated
04/06/2016
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