Provider Demographics
NPI:1093336083
Name:MERCURY PHARMACY CORPORATION
Entity Type:Organization
Organization Name:MERCURY PHARMACY CORPORATION
Other - Org Name:CENTRAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:DUENAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:707-200-4411
Mailing Address - Street 1:2300 MACDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-1878
Mailing Address - Country:US
Mailing Address - Phone:510-234-4381
Mailing Address - Fax:510-234-7803
Practice Address - Street 1:2300 MACDONALD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-1878
Practice Address - Country:US
Practice Address - Phone:510-234-4381
Practice Address - Fax:510-234-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy