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General NPI Number Information
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NPI Number | 1285259473
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Entity Type | Organization
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Legal Business Name | ADVANCE SJ PHARMACY, INC
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 2331A MONTPELIER DR STE A-10
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City | SAN JOSE
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State | CA
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Zip | 95116-1614
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Country | US
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Telephone | 408-449-5755
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Fax |
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Provider Business Mailing Address
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Address Line | 2331A MONTPELIER DR STE A-10
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City | SAN JOSE
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State | CA
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Zip | 95116-1614
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Country | US
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Telephone | 408-449-5755
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Fax | 408-484-6379
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Authorized Official
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Title or Position | PHARMACIST
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Name | CATHY THAI
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Credential | PHARMD
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Telephone | 408-449-5755
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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 |
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License Number State |
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