DT Pharmacy Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY50623 Issued in CA

Legal business name

DT PHARMACY CORPORATION

Practice address

4616 El Cajon Blvd
Ste 6
San Diego, CA 92115-4490

Phone

(619) 563-8212

Fax

(619) 563-8211

NPI assigned

Jul 11, 2005

Organization subpart

No

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

Authorized official

Name

Phuongdung Nguyen

Title

Owner/President

Phone

(714) 331-4551

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Viet Pharmacy and Medical Supplies Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

DT Pharmacy Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• DT Pharmacy Corporation

  • Community/Retail Pharmacy
  • San Diego, CA
  • NPI 1912362377
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phuongddung Nguyen

  • Pharmacist
  • San Diego, CA
  • NPI 1114248689
  NPD
• Viet Thuc Truong, PHARM.D

  • Pharmacist
  • San Diego, CA
  • NPI 1821108028
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1790783025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 EL CAJON BLVD",
            "address_2": "STE 6",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154490",
            "telephone_number": "619-563-8212",
            "fax_number": "619-563-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 EL CAJON BLVD",
            "address_2": "STE 6",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154490",
            "telephone_number": "619-563-8212",
            "fax_number": "619-563-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DT PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PHUONGDUNG",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "714-331-4551"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA22580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130131",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Viet Pharmacy and Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leanne M Drusen, PHARMD
• Brittany Drutman, DO
• Julia Claire Dryden
• Kaitlyn E Dryzmala, M.S., CCC-SLP
• Monika Drzymalski, DO
• DT Pharmacy Corporation
• Kayla Rene Du Bois, PA-C
• Mary Walch Du Quette, M.D.
• Genuvere Guenette Du Ville, MFT
• Clarisa Pelayo Du, NP

• Community/Retail Pharmacy in San Diego, CA
• Providers in San Diego, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.