Healthcare Provider Details

I. General information

NPI: 1174670228
Provider Name (Legal Business Name): HUTRX PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 COLUSA AVE
YUBA CITY CA
95991-3734
US

IV. Provider business mailing address

737 COLUSA AVE
YUBA CITY CA
95991-3734
US

V. Phone/Fax

Practice location:
  • Phone: 530-674-3550
  • Fax: 530-673-6288
Mailing address:
  • Phone: 530-674-3550
  • Fax: 530-673-6288

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 NumberPHY54526
License Number StateCA

VIII. Authorized Official

Name: HIENG TANG
Title or Position: OWNER
Credential: PHRMD
Phone: 530-674-3550