Provider Demographics
NPI:1114383296
Name:TOTAL CARE RX PHARMACY INC
Entity Type:Organization
Organization Name:TOTAL CARE RX PHARMACY INC
Other - Org Name:TOTAL CARE RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/ PIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINH
Authorized Official - Middle Name:M
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-964-4004
Mailing Address - Street 1:18682 BEACH BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2048
Mailing Address - Country:US
Mailing Address - Phone:714-964-4004
Mailing Address - Fax:714-964-4166
Practice Address - Street 1:18682 BEACH BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2048
Practice Address - Country:US
Practice Address - Phone:714-964-4004
Practice Address - Fax:714-964-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1114383296Medicaid