Healthcare Provider Details

I. General information

NPI: 1679515456
Provider Name (Legal Business Name): SENTER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 02/20/2017
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: 408-228-6056
Mailing address:
  • Phone: 408-287-4899
  • Fax: 408-287-4898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47320
License Number StateCA

VIII. Authorized Official

Name: LEN DU
Title or Position: PRESIDENT
Credential: RPH
Phone: 408-482-9167