MEDICARE: NHONS PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PHY36010	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457566499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NHONS PHARMACY

Provider Business Mailing Address
First Line	:	1412 ROSEMARIE LN
Second Line	:	SUITE C
City	:	STOCKTON
State	:	CA
Zip	:	95207-6970
Country	:	US
Telephone Number	:	209-473-4277
Fax Number	:	209-473-4278

Provider Business Practice Location Address
First Line	:	1412 ROSEMARIE LN
Second Line	:	SUITE C
City	:	STOCKTON
State	:	CA
Zip	:	95207-6970
Country	:	US
Telephone Number	:	209-473-4277
Fax Number	:	209-473-4278

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	MR. NHON T VIEN
Credential	:	PHARMACIST
Telephone Number	:	209-473-4277

Provider Enumeration Date	:	05/12/2007
Last Update Date	:	07/29/2008

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