Organization
DISCO REX PHARMACY INC
Active
Other names
DISCO REX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
YU FUN THOMAS LAI (PRESIDENT)
(650) 326-3873
Entity
Organization
Contact information
Practice address
328 UNIVERSITY AVE, PALO ALTO, CA 94301-1715
(650) 326-3873
(650) 326-0403
Mailing address
328 UNIVERSITY AVE, PALO ALTO, CA 94301-1715
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHY33116
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0540357
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA331160
—
CA
Enumeration date
09/12/2006
Last updated
10/09/2007
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