Provider Demographics
NPI:1205218773
Name:PNR PHARMA INC
Entity Type:Organization
Organization Name:PNR PHARMA INC
Other - Org Name:CAREMAX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-530-2888
Mailing Address - Street 1:10741 WESTMINSTER AVE # C
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4919
Mailing Address - Country:US
Mailing Address - Phone:714-530-2888
Mailing Address - Fax:714-530-4777
Practice Address - Street 1:10741 WESTMINSTER AVE # C
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4919
Practice Address - Country:US
Practice Address - Phone:714-530-2888
Practice Address - Fax:714-530-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 532953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY 53295OtherSTATE BOARD OF PHARMACY
CA56-56004OtherNCPDP PROVIDER