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General NPI Number Information
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NPI Number | 1376489773
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH PHARMACY CORPORATION
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 9483 CAMINO RUIZ STE C
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City | SAN DIEGO
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State | CA
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Zip | 92126-4472
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Country | US
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Telephone | 858-253-8337
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Fax | 858-253-8424
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Provider Business Mailing Address
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Address Line | 9483 CAMINO RUIZ STE C
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City | SAN DIEGO
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State | CA
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Zip | 92126-4472
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Country | US
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Telephone | 858-253-8337
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Fax | 858-253-8424
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIEN THAI BACH
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Credential |
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Telephone | 858-253-8337
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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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