=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457566499
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NHONS PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2007
-----------------------------------------------------
Last Update Date | 07/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1412 ROSEMARIE LN SUITE C
-----------------------------------------------------
City | STOCKTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95207-6970
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-473-4277
-----------------------------------------------------
Fax | 209-473-4278
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1412 ROSEMARIE LN SUITE C
-----------------------------------------------------
City | STOCKTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95207-6970
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-473-4277
-----------------------------------------------------
Fax | 209-473-4278
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST/OWNER
-----------------------------------------------------
Name | MR. NHON T VIEN
-----------------------------------------------------
Credential | PHARMACIST
-----------------------------------------------------
Telephone | 209-473-4277
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PHY36010
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------