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General NPI Number Information
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NPI Number | 1568641082
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Entity Type | Organization
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Legal Business Name | SARATOGA PHARMACY LLC
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 991 SARATOGA AVE STE 140
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City | SAN JOSE
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State | CA
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Zip | 95129-2335
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Country | US
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Telephone | 408-873-9881
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Fax | 408-873-9882
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Provider Business Mailing Address
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Address Line | 1987 EDGEBANK DR
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City | SAN JOSE
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State | CA
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Zip | 95122-4017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | CATHERINE CHINH TUONG MAI
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Credential |
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Telephone | 408-893-1441
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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 | 48834
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License Number State | CA
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