Provider Demographics
NPI:1255844502
Name:ARMSTRONG, AGNES CRUZ (RPH)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:CRUZ
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25511 MUIRLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4742
Mailing Address - Country:US
Mailing Address - Phone:949-454-6601
Mailing Address - Fax:949-454-6610
Practice Address - Street 1:25511 MUIRLANDS BLVD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4742
Practice Address - Country:US
Practice Address - Phone:949-454-6601
Practice Address - Fax:949-454-6610
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist