Provider Demographics
NPI:1871667394
Name:MAX RX GROUP INC
Entity Type:Organization
Organization Name:MAX RX GROUP INC
Other - Org Name:HUNG JEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:626-571-2928
Mailing Address - Street 1:1336 W VALLEY BLVD #B
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803
Mailing Address - Country:US
Mailing Address - Phone:626-571-2928
Mailing Address - Fax:626-571-6479
Practice Address - Street 1:1336 W VALLEY BLVD #B
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803
Practice Address - Country:US
Practice Address - Phone:626-571-2928
Practice Address - Fax:626-571-6479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY51220333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0536980OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CAPHY51220OtherCALIFORNIA STATE BOARD OF PHARMACY RETAIL PERMIT