Provider Demographics
NPI:1356105902
Name:COUNTY OF RIVERISDE
Entity type:Organization
Organization Name:COUNTY OF RIVERISDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING CLINICAL PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:THU
Authorized Official - Middle Name:KIEU NGUYEN
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-486-4613
Mailing Address - Street 1:26520 CACTUS AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3927
Mailing Address - Country:US
Mailing Address - Phone:951-486-4529
Mailing Address - Fax:951-486-4497
Practice Address - Street 1:26520 CACTUS AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-3927
Practice Address - Country:US
Practice Address - Phone:951-486-4529
Practice Address - Fax:951-486-4497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF RIVERISDE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy