Provider Demographics
NPI:1679509251
Name:U.N. PHARMCAY
Entity Type:Organization
Organization Name:U.N. PHARMCAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:Q
Authorized Official - Last Name:VUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-477-1770
Mailing Address - Street 1:3652 MARKET ST
Mailing Address - Street 2:UNIT C-1
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-1298
Mailing Address - Country:US
Mailing Address - Phone:404-477-1770
Mailing Address - Fax:404-299-0899
Practice Address - Street 1:3652 MARKET ST
Practice Address - Street 2:UNIT C-1
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-1298
Practice Address - Country:US
Practice Address - Phone:404-477-1770
Practice Address - Fax:404-299-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0089163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========Medicare ID - Type Unspecified