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General NPI Number Information
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NPI Number | 1730163403
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Entity Type | Organization
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Legal Business Name | FAMILY PHARMACY
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 10240 WESTMINSTER AVE SUITE #104
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4855
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Country | US
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Telephone | 714-534-7656
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Fax | 714-534-4424
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Provider Business Mailing Address
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Address Line | 10240 WESTMINSTER AVE SUITE #104
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4855
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Country | US
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Telephone | 714-534-7656
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Fax | 714-534-4424
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE / OWNER
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Name | MRS. KIMHUE THI DU
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Credential | RPH
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Telephone | 714-534-7656
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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 | PHY36119
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License Number State | CA
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