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General NPI Number Information
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NPI Number | 1912323155
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Entity Type | Organization
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Legal Business Name | MERCURY PHARMACY CORPORATION
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 3495 SONOMA BLVD STE K
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City | VALLEJO
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State | CA
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Zip | 94590-2984
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Country | US
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Telephone | 707-200-4411
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Fax | 707-652-5906
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Provider Business Mailing Address
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Address Line | 5233 REEDLEY WAY
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-1502
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Country | US
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Telephone | 707-200-4411
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Fax | 707-652-5906
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Authorized Official
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Title or Position | CEO
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Name | RICARDO ANGEL DUENAS
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Credential |
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Telephone | 707-200-4411
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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 | 51790
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License Number State | CA
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