| NPI | 1811317936 |
|---|---|
| Doing Business As | MDRX COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JACQUELINE T NGUYEN President 800-567-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 50255) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 50255) |
| 305S00000X Point of Service (Licence: CA 50255) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |