Healthcare Provider Details

I. General information

NPI: 1346779832
Provider Name (Legal Business Name): DDE RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18491 COLIMA RD
ROWLAND HEIGHTS CA
91748-2805
US

IV. Provider business mailing address

18491 COLIMA RD
ROWLAND HEIGHTS CA
91748-2805
US

V. Phone/Fax

Practice location:
  • Phone: 626-581-3133
  • Fax: 626-581-4422
Mailing address:
  • Phone: 626-581-3133
  • Fax: 626-581-4422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number46526
License Number StateCA

VIII. Authorized Official

Name: MS. DING MEE NGUI
Title or Position: CEO
Credential:
Phone: 626-581-3133