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General NPI Number Information
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NPI Number | 1972071900
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Entity Type | Organization
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Legal Business Name | MERCY PHARMACY LLC
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 13556 RARITAN ST
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City | WESTMINSTER
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State | CO
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Zip | 80234-1035
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Country | US
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Telephone | 720-232-6735
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Fax |
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Provider Business Mailing Address
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Address Line | 13556 RARITAN ST
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City | WESTMINSTER
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State | CO
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Zip | 80234-1035
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Country | US
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Telephone | 720-232-6735
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BICHVAN NGUYEN TRUONG
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Credential | PHARMACIST
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Telephone | 720-232-6735
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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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