Organization
MTT PHARMACY INC
Active
Other names
VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THAO P. NGUYEN (SECRETARY/PHARMACIST IN CHARGE)
(530) 633-2819
Entity
Organization
Contact information
Practice address
414 MAIN ST, WHEATLAND, CA 95692-9422
(530) 633-2819
(530) 633-0159
Mailing address
414 MAIN ST, WHEATLAND, CA 95692-9422
(530) 633-2819
(530) 633-0159
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY37030
CA
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY37030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0550031
OTHER ID NUMBER
—
05
—
PHA370300
—
CA
Enumeration date
08/31/2006
Last updated
05/09/2019
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