Healthcare Provider Details

I. General information

NPI: 1619721461
Provider Name (Legal Business Name): PHARMATRON A PHARMACY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARK CREEK DR STE 101
CLOVIS CA
93611-4461
US

IV. Provider business mailing address

400 PARK CREEK DR STE 101
CLOVIS CA
93611-4461
US

V. Phone/Fax

Practice location:
  • Phone: 559-712-5828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: TUAN LE
Title or Position: OWNER
Credential:
Phone: 559-712-5828