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General NPI Number Information
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NPI Number | 1437310125
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Entity Type | Organization
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Legal Business Name | MISSION PHARMACY
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1050 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3403
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Country | US
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Telephone | 562-436-7257
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Fax | 562-436-8998
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Provider Business Mailing Address
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Address Line | 1050 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3403
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Country | US
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Telephone | 562-436-7257
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Fax | 562-436-8998
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Authorized Official
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Title or Position | OWNER
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Name | TUNG VAN VU
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Credential | PHARMACIST
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Telephone | 562-436-7257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHA38002
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License Number State |
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