Provider Demographics
NPI:1235643628
Name:NHAN HOA PHARMACY
Entity Type:Organization
Organization Name:NHAN HOA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-898-8888
Mailing Address - Street 1:7761 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4200
Mailing Address - Country:US
Mailing Address - Phone:714-248-9663
Mailing Address - Fax:714-248-9683
Practice Address - Street 1:7761 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4200
Practice Address - Country:US
Practice Address - Phone:714-248-9663
Practice Address - Fax:714-248-9683
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NHAN HOA COMPREHENSIVE HEALTH CARE CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY544963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy