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General NPI Number Information
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NPI Number | 1427519842
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Entity Type | Organization
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Legal Business Name | ACCESS MYRX PHARMACY LLC
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 04/08/2019
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Provider Practice Location Address
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Address Line | 9632 EMERALD OAK DR STE G
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City | ELK GROVE
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State | CA
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Zip | 95624-2258
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Country | US
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Telephone | 916-479-0615
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Fax |
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Provider Business Mailing Address
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Address Line | 9632 EMERALD OAK DR STE G
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City | ELK GROVE
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State | CA
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Zip | 95624-2258
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Country | US
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Telephone | 916-479-0615
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | DAVID LY
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Credential |
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Telephone | 916-509-9834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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