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Angkor Pharmacy

Debarred entity

Angkor Pharmacy is an entity of interest. It has not been found on international sanctions lists.

Type	Company				[sources]
Name	Angkor Pharmacy				[sources]
Incorporation date	not available				[sources]
Jurisdiction	not available				[sources]
Country	United States				[sources]
Description	License number(s): PHY 53262 · Provider number(s): 1306939749				[sources]
Registration number	not available				[sources]
Sector	Entity/Corporation				[sources]
Address	4555 North Pershing Ave., Ste. 7, Stockton, CA, 95207				[sources]
Last change	2024-11-07	Last processed	2024-11-07	First seen	2024-11-07

Sanctions
Authority	Program	Start date	End date
Department of Health Care Services	-	2021-06-14	-

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States · DHCS

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