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General NPI Number Information
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NPI Number | 1902396252
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Entity Type | Organization
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Legal Business Name | SACRX CORPORATION
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Dates
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Enumeration Date | 05/12/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 6540 STOCKTON BLVD #3B
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City | SACRAMENTO
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State | CA
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Zip | 95823-1635
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Country | US
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Telephone | 916-701-5688
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Fax | 916-701-5687
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Provider Business Mailing Address
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Address Line | 6540 STOCKTON BLVD #3B
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City | SACRAMENTO
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State | CA
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Zip | 95823-1635
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Country | US
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Telephone | 916-701-5688
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Fax | 916-701-5687
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Authorized Official
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Title or Position | OWNER/AO
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Name | TOAN BUI
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Credential |
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Telephone | 916-730-7116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY56125
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License Number State | CA
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