=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487765673
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OUYE'S PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2130 10TH ST
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95818-1314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-444-7370
-----------------------------------------------------
Fax | 916-444-7872
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2130 10TH ST
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95818-1314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-444-7370
-----------------------------------------------------
Fax | 916-444-7872
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | LLOYD OUYE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 916-444-7370
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28311
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------