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General NPI Number Information
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NPI Number | 1265699219
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Entity Type | Organization
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Legal Business Name | SACTO PHARMACY
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 5033 STOCKTON BOULEVARD
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City | SACRAMENTO
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State | CA
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Zip | 95820-5407
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Country | US
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Telephone | 916-454-0168
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Fax | 916-454-5949
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Provider Business Mailing Address
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Address Line | 5033 STOCKTON BOULEVARD
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City | SACRAMENTO
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State | CA
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Zip | 95820-5407
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Country | US
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Telephone | 916-454-0168
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Fax | 916-454-5949
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Authorized Official
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Title or Position | PHARMACIST
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Name | HUE KIM VO
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Credential | R PH
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Telephone | 916-454-0168
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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 | PHY36774
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License Number State | CA
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