Healthcare Provider Details

I. General information

NPI: 1376589762
Provider Name (Legal Business Name): SMS AND DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 10/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 SAND CANYON AVE SUITE 101
IRVINE CA
92618-3711
US

IV. Provider business mailing address

16300 SAND CANYON AVE SUITE 101
IRVINE CA
92618-3711
US

V. Phone/Fax

Practice location:
  • Phone: 949-453-9789
  • Fax: 949-453-9235
Mailing address:
  • Phone: 949-453-9789
  • Fax: 949-453-9235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY48763
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SAU TRAN
Title or Position: PIC
Credential: BS
Phone: 949-453-9789