Provider Demographics
NPI:1376898106
Name:DRUG PHARM INC.
Entity Type:Organization
Organization Name:DRUG PHARM INC.
Other - Org Name:EL PORTAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-940-4186
Mailing Address - Street 1:2527 DEAUVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-2839
Mailing Address - Country:US
Mailing Address - Phone:559-940-4186
Mailing Address - Fax:559-297-4128
Practice Address - Street 1:3377 G ST STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-0964
Practice Address - Country:US
Practice Address - Phone:209-384-8880
Practice Address - Fax:209-384-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
CA508953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5644364OtherNCPDP PROVIDER IDENTIFICATION NUMBER