Provider Demographics
NPI:1457345407
Name:THU INC
Entity Type:Organization
Organization Name:THU INC
Other - Org Name:THU PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST INCHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:916-395-0352
Mailing Address - Street 1:6590 STOCKTON BLVD
Mailing Address - Street 2:# B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-1612
Mailing Address - Country:US
Mailing Address - Phone:916-395-0352
Mailing Address - Fax:916-395-1878
Practice Address - Street 1:6590 STOCKTON BLVD
Practice Address - Street 2:# B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1612
Practice Address - Country:US
Practice Address - Phone:916-395-0352
Practice Address - Fax:916-395-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY407563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6478200001Medicare NSC