Provider Demographics
NPI:1033477930
Name:TAFT PHARMACEUTICAL INC
Entity Type:Organization
Organization Name:TAFT PHARMACEUTICAL INC
Other - Org Name:TAFT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:DIEP
Authorized Official - Middle Name:N
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-209-5678
Mailing Address - Street 1:5421 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-3005
Mailing Address - Country:US
Mailing Address - Phone:714-209-5678
Mailing Address - Fax:
Practice Address - Street 1:5421 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-3005
Practice Address - Country:US
Practice Address - Phone:714-209-5678
Practice Address - Fax:714-769-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY509023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy