=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538223953
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRST PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 08/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9262 BOLSA AVE STE A
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-8905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-896-9518
-----------------------------------------------------
Fax | 714-896-9618
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9262 BOLSA AVE STE A
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-8905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-896-9518
-----------------------------------------------------
Fax | 714-896-9618
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | MRS. T VU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-896-9518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH43879
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------