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General NPI Number Information
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NPI Number | 1649782541
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Entity Type | Organization
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Legal Business Name | VITALITY RX
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 210 BLUE RAVINE RD STE 170
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City | FOLSOM
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State | CA
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Zip | 95630-4796
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Country | US
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Telephone | 916-293-8687
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Fax | 916-293-8637
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Provider Business Mailing Address
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Address Line | 210 BLUE RAVINE RD STE 170
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City | FOLSOM
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State | CA
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Zip | 95630-4796
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Country | US
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Telephone | 916-293-8687
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Fax | 916-293-8637
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Authorized Official
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Title or Position | OWNER
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Name | DR. NHATDUY TON
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Credential | PHARM.D.
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Telephone | 916-293-8687
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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 |
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License Number State |
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