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General NPI Number Information
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NPI Number | 1447625769
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Entity Type | Organization
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Legal Business Name | MED CHOICE PHARMACY INC
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 621 N EUCLID ST B
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City | ANAHEIM
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State | CA
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Zip | 92801-4615
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Country | US
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Telephone | 714-533-3080
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Fax | 714-533-3090
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Provider Business Mailing Address
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Address Line | 621 N EUCLID ST B
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City | ANAHEIM
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State | CA
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Zip | 92801-4615
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Country | US
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Telephone | 714-533-3080
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Fax | 714-533-3090
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Authorized Official
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Title or Position | PRESIDNET/PIC
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Name | MR. THOMAS N DUONG
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Credential | RPH
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Telephone | 714-533-3080
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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 | PHY 53846
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License Number State | CA
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