MEDICARE: AUDREY PHARMACY INC

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	3336C0003X	Community/Retail Pharmacy	51695	CA

General Provider Information

NPI Number	:	1457782526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUDREY PHARMACY INC

Provider Business Mailing Address
First Line	:	9822 BOLSA AVE
Second Line	:	SUITE # G
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6698
Country	:	US
Telephone Number	:	714-531-1244
Fax Number	:

Provider Business Practice Location Address
First Line	:	9822 BOLSA AVE
Second Line	:	SUITE # G
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6698
Country	:	US
Telephone Number	:	714-531-1244
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AUDREY VU
Credential	:
Telephone Number	:	714-531-1244

Provider Enumeration Date	:	11/27/2013
Last Update Date	:	12/11/2025

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