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General NPI Number Information
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NPI Number | 1154431393
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Entity Type | Organization
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Legal Business Name | SMART COMPUTER INC.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/06/2013
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Provider Practice Location Address
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Address Line | 1428 S SAN GABRIEL BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3656
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Country | US
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Telephone | 626-280-3060
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Fax | 626-280-1215
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Provider Business Mailing Address
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Address Line | 1428 S SAN GABRIEL BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3656
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Country | US
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Telephone | 626-280-3060
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Fax | 626-280-1215
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | NINA WU
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Credential | PHARMACIST
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Telephone | 626-280-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY45392
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License Number State | CA
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