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General NPI Number Information
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NPI Number | 1992109722
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Entity Type | Organization
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Legal Business Name | MEDS ENVY, INC.
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 404 E 4TH ST
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City | PERRIS
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State | CA
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Zip | 92570-2201
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Country | US
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Telephone | 951-943-1575
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Fax | 951-943-1577
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Provider Business Mailing Address
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Address Line | 404 E 4TH ST
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City | PERRIS
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State | CA
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Zip | 92570-2201
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Country | US
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Telephone | 951-943-1575
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YONG SOON CHANG
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Credential |
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Telephone | 951-943-1575
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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 | PHY55830
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License Number State | CA
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