DONG TAM CORPORATION (ROSA PHARMACY) - NPI NUMBER 1487640488

Summary

Provider Name: DONG TAM CORPORATION (ROSA PHARMACY)

NPI Number: 1487640488

Clasification: Durable Medical Equipment & Medical Supplies (332BX2000X)

Specialization: Oxygen Equipment & Supplies

Address:
9200 E VALLEY BLVD
ROSEMEAD, CA
ZIP 91770

Phone Number: (626) 573-9477



Detailed Information

DONG TAM CORPORATION is an oxygen equipment & supplies durable medical equipment & medical supplies in Rosemead, CA. The assigned NPI number for this provider is 1487640488 and is registered as an organization entity type.
The provider Is Doing Business As Rosa Pharmacy.

The provider's business address is:

9200 E VALLEY BLVD
ROSEMEAD, CA
ZIP 91770-900
Phone: (626) 573-9477

The provider's authorized official is Linh Nghi Pham .
The authorized official title is Manager and has the following contact phone number (626) 573-9477.

The enumeration date for this NPI number is 9/25/2005 and was last updated on 7/1/2008.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1013958925 GARFIELD BEACH CVS LLC
Durable Medical Equipment & Medical Supplies
1316261282 ONCOLOGY CARE MEDICAL ASSOCIATES
Durable Medical Equipment & Medical Supplies
1366646218 WILBUR HOME HEALTH CARE & MEDICAL SUPPLY INC
Durable Medical Equipment & Medical Supplies
1083774616 STANLEY LAU
Durable Medical Equipment & Medical Supplies
1164402921 TOMKIY, INC
Durable Medical Equipment & Medical Supplies
1265447551 WALGREEN CO
Durable Medical Equipment & Medical Supplies
1316990963 OPTIMAL REHAB, INC.
Durable Medical Equipment & Medical Supplies

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies PHY41508 CA No
2 3336C0003X Pharmacy Community/Retail Pharmacy PHY41508 CA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 1273920001 MEDICARE NSC CA
2 0535952 OTHER NABP
3 PHA415080 MEDICAID CA

NPI Record

No. Field Name Field Value
1 NPI 1487640488
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name DONG TAM CORPORATION
5 Provider Other Organization Name ROSA PHARMACY
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 9200 E VALLEY BLVD
8 Provider Business Practice Location Address City Name ROSEMEAD
9 Provider Business Practice Location Address State Name CA
10 Provider Business Practice Location Address Postal Code 917701900
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 6265739477
13 Provider Enumeration Date 9/25/2005
14 Last Update Date 7/1/2008
15 Authorized Official Last Name PHAM
16 Authorized Official First Name LINH
17 Authorized Official Middle Name NGHI
18 Authorized Official Title or Position MANAGER
19 Authorized Official Telephone Number 6265739477
20 Healthcare Provider Taxonomy Code 1 332BX2000X
21 Provider License Number 1 PHY41508
22 Provider License Number State Code 1 CA
23 Healthcare Provider Primary Taxonomy Switch 1 N
24 Healthcare Provider Taxonomy Code 2 3336C0003X
25 Provider License Number 2 PHY41508
26 Provider License Number State Code 2 CA
27 Healthcare Provider Primary Taxonomy Switch 2 Y
28 Other Provider Identifier 1 1273920001
29 Other Provider Identifier Type Code 1 07
30 Other Provider Identifier State 1 CA
31 Other Provider Identifier 2 0535952
32 Other Provider Identifier Type Code 2 01
33 Other Provider Identifier Issuer 2 NABP
34 Other Provider Identifier 3 PHA415080
35 Other Provider Identifier Type Code 3 05
36 Other Provider Identifier State 3 CA
37 Is Organization Subpart N
38 Authorized Official Name Prefix Text MISS

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.