Bunnaun Uch
Pharmacy, Long Term Care Pharmacy in Stockton, CA. Organization (NPI-2).
NPI number1306939749
StatusActive
Last updated in NPPESJun 15, 2020
Details
- NPI
- 1306939749
- Entity type
- Organization (NPI-2)
- Legal business name
- Bunnaun Uch
- Organization subpart
- No
- Enumeration date
- Sep 30, 2006
- Certification date
- Jun 15, 2020
- Last updated
- Jun 15, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – | Yes |
Other names
- Angkor Pharmacy (Doing Business As)
Practice location
4555 N Pershing AveSte 7
Stockton, CA 95207-6740
Phone 209-888-2099 · Fax 209-888-2105
Mailing address
4555 N Pershing AveSte 7
Stockton, CA 95207-6740
Phone 209-473-4706 · Fax 209-473-7377
Authorized official
Bunnaun Uch
Owner/Pic
2098882099
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