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General NPI Number Information
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NPI Number | 1649748112
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Entity Type | Organization
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Legal Business Name | ENTIRELYPETS PHARMACY, LLC.
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 34571 7TH ST
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City | UNION CITY
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State | CA
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Zip | 94587-3673
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Country | US
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Telephone | 800-738-7209
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Fax |
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Provider Business Mailing Address
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Address Line | 34571 7TH ST
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City | UNION CITY
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State | CA
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Zip | 94587-3673
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Country | US
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Telephone | 800-738-7209
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ALAN CHANG
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Credential |
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Telephone | 800-738-7209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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