MEDICARE: EUCLID 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	3336C0003X	Community/Retail Pharmacy	PHY39715	CA

General Provider Information

NPI Number	:	1528194065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUCLID PHARMACY

Provider Business Mailing Address
First Line	:	4268 EUCLID AVENUE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4977
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4268 EUCLID AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4977
Country	:	US
Telephone Number	:	619-280-9203
Fax Number	:	619-280-9202

Authorized Official
Title or Position	:	PHARMACY TECHNICIAN
Name	:	FRANCES T. HUYNH
Credential	:
Telephone Number	:	619-280-9203

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	01/25/2008

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