Provider Demographics
NPI:1851173496
Name:DRAGON RX LLC
Entity Type:Organization
Organization Name:DRAGON RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, APH
Authorized Official - Phone:626-818-5338
Mailing Address - Street 1:407 W VALLEY BLVD UNIT 7
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3359
Mailing Address - Country:US
Mailing Address - Phone:626-310-0504
Mailing Address - Fax:626-310-0465
Practice Address - Street 1:407 W VALLEY BLVD UNIT 7
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-3359
Practice Address - Country:US
Practice Address - Phone:626-310-0504
Practice Address - Fax:626-310-0465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health