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General NPI Number Information
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NPI Number | 1528416757
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Entity Type | Organization
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Legal Business Name | CVS/PHARMACY
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 1097 LEIGH AVE
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City | SAN JOSE
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State | CA
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Zip | 95126-4153
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Country | US
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Telephone | 408-294-2240
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Fax |
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Provider Business Mailing Address
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Address Line | 1097 LEIGH AVE
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City | SAN JOSE
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State | CA
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Zip | 95126-4153
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Country | US
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Telephone | 408-294-2240
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. UYEN PHUONG HOANG
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Credential | PHARMD
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Telephone | 408-679-8259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 50306
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License Number State | CA
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