Provider Demographics
NPI:1235692864
Name:LAVERNE HUYNH-PHAN
Entity Type:Organization
Organization Name:LAVERNE HUYNH-PHAN
Other - Org Name:SCRIPT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LAVERNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH-PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:559-324-1808
Mailing Address - Street 1:255 W HERNDON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0381
Mailing Address - Country:US
Mailing Address - Phone:559-324-1808
Mailing Address - Fax:
Practice Address - Street 1:255 W HERNDON AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0381
Practice Address - Country:US
Practice Address - Phone:559-324-1808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy