Healthcare Provider Details

I. General information

NPI: 1407968498
Provider Name (Legal Business Name): JAMES' MERCY SOUTHWEST PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OLD RIVER RD SUITE 125
BAKERSFIELD CA
93311
US

IV. Provider business mailing address

500 OLD RIVER RD SUITE 125
BAKERSFIELD CA
93311
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-0977
  • Fax: 661-663-0991
Mailing address:
  • Phone: 661-663-0977
  • Fax: 661-663-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY41531
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES FENG YANG
Title or Position: OWNER/ PRESIDENT
Credential: PHARMD
Phone: 864-529-7419