Healthcare Provider Details

I. General information

NPI: 1336119213
Provider Name (Legal Business Name): NEW SUTTER PROFESSIONAL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 SUTTER ST SUITE 101
SAN FRANCISCO CA
94115-3037
US

IV. Provider business mailing address

2300 SUTTER ST SUITE 101
SAN FRANCISCO CA
94115-3037
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-3223
  • Fax: 415-567-2633
Mailing address:
  • Phone: 415-567-3223
  • Fax: 415-567-2633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY48918
License Number StateCA

VIII. Authorized Official

Name: TERRY CHU
Title or Position: OWNER/PRESIDENT
Credential: PHRMD
Phone: 916-704-9599