Organization
THANH TAM PHARMACY INC
Active
Other names
Pacific Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
XUAN TRIEU (PRESIDENT)
(714) 839-1197
Entity
Organization
Contact information
Practice address
9898 BOLSA AVE, WESTMINSTER, CA 92683-6677
(714) 839-1197
(714) 839-1196
Mailing address
9898 BOLSA AVE, WESTMINSTER, CA 92683-6677
(714) 839-1197
(714) 839-1196
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY50504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851482442
—
CA
01
—
2128998
PK
—
Enumeration date
09/27/2006
Last updated
02/24/2017
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