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General NPI Number Information
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NPI Number | 1356699722
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Entity Type | Organization
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Legal Business Name | MOWRY PLAZA PHARMACY INC
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 668 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94536-4113
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Country | US
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Telephone | 510-745-9900
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Fax | 510-745-9950
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Provider Business Mailing Address
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Address Line | 668 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94536-4113
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Country | US
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Telephone | 510-745-9900
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Fax | 510-745-9950
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMARJEAN BASRAI
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Credential |
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Telephone | 510-745-9900
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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 | 51006
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License Number State | CA
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