Provider Demographics
NPI:1871033514
Name:ALLIANCE PHARMACY, INC
Entity type:Organization
Organization Name:ALLIANCE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BON
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-200-8054
Mailing Address - Street 1:1585 W BROADWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1358
Mailing Address - Country:US
Mailing Address - Phone:657-200-8054
Mailing Address - Fax:844-331-2316
Practice Address - Street 1:1585 W BROADWAY
Practice Address - Street 2:SUITE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1358
Practice Address - Country:US
Practice Address - Phone:657-200-8054
Practice Address - Fax:844-331-2316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy