Provider Demographics
NPI:1174060248
Name:NEWBURY PHARMACY INC
Entity type:Organization
Organization Name:NEWBURY PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:DANG
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:657-616-0976
Mailing Address - Street 1:9430 WARNER AVE STE G
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2826
Mailing Address - Country:US
Mailing Address - Phone:657-616-0976
Mailing Address - Fax:657-244-8183
Practice Address - Street 1:9430 WARNER AVE STE G
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2826
Practice Address - Country:US
Practice Address - Phone:657-616-0976
Practice Address - Fax:657-244-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacyGroup - Single Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59594OtherBOARD OF PHARMACY