Organization
DT PHARMACY CORPORATION
Active
Other names
Viet Pharmacy and Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
PHUONGDUNG NGUYEN (OWNER/PRESIDENT)
(714) 331-4551
Entity
Organization
Contact information
Practice address
4616 EL CAJON BLVD, STE 6, SAN DIEGO, CA 92115-4490
(619) 563-8212
(619) 563-8211
Mailing address
4616 EL CAJON BLVD, STE 6, SAN DIEGO, CA 92115-4490
(619) 563-8212
(619) 563-8211
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY50623
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130131
PK
—
05
—
PHA22580
—
CA
Enumeration date
07/11/2005
Last updated
07/08/2015
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