NPI: 1104217165 · LEMON GROVE, CA 91945 · Pharmacy · NPI assigned 02/12/2015
| Authorized Official | NGUYEN, VINCENT (CEO/CFO/SEC/DIR) |
| NPI Enumeration Date | 02/12/2015 |
Other providers sharing the same authorized official: NGUYEN, VINCENT
| Provider | City | State | Total Paid |
|---|---|---|---|
| BROADWAY PHARMACY CORPORATION | SPRING VALLEY | CA | $2K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 181 | $7K |