Healthcare Provider Details

I. General information

NPI: 1871793679
Provider Name (Legal Business Name): SENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2643 SENTER RD STE A
SAN JOSE CA
95111-1184
US

IV. Provider business mailing address

2643 SENTER RD STE A
SAN JOSE CA
95111-1184
US

V. Phone/Fax

Practice location:
  • Phone: 408-287-4899
  • Fax: 408-287-4898
Mailing address:
  • Phone: 408-287-4899
  • Fax: 408-287-4898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5740240001
License Number StateCA

VIII. Authorized Official

Name: LEN DU
Title or Position: OWNER/RPH
Credential: RPH
Phone: 408-287-4899