Provider Demographics
NPI:1972071900
Name:MERCY PHARMACY LLC
Entity type:Organization
Organization Name:MERCY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BICHVAN
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:720-232-6735
Mailing Address - Street 1:13556 RARITAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-1035
Mailing Address - Country:US
Mailing Address - Phone:720-232-6735
Mailing Address - Fax:
Practice Address - Street 1:13556 RARITAN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-1035
Practice Address - Country:US
Practice Address - Phone:720-232-6735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy