Van Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY41834 Issued in CA

Legal business name

VAN PHARMACY

Practice address

4502 N Pershing Ave
#Ab
Stockton, CA 95207

Phone

(209) 478-9868

Fax

(209) 478-6930

NPI assigned

Oct 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Van Thi Hong Dang, RPH

Title

Pharmacist in Charge Owner

Phone

(209) 478-9868

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1336221910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 N PERSHING AVE",
            "address_2": "#AB",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-478-9868",
            "fax_number": "209-478-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 N PERSHING AVE",
            "address_2": "#AB",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-478-9868",
            "fax_number": "209-478-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "THI HONG",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE  OWNER",
        "authorized_official_telephone_number": "209-478-9868",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY41834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA418340",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "RPH43745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "PHY41834",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Van Gorkom
• Christine Marie Van Horn, MD, MS
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• Jennilee Keshet Van Nes, MFT ASSOCIATE
• Breanna Van Pernis
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• Alexandra Van Zuyen
• Shylah Vanasse
• Vance Marriage and Family Therapy, Inc.
• Carole Marie Vance, LMFT

• Pharmacy in Stockton, CA
• Providers in Stockton, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.