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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]
NPI	`1306939749`				[sources]
Registration number	`PHY 53262`				[sources]
Sector	Entity/Corporation				[sources]
Address	4555 North Pershing Ave., Ste. 7, Stockton, CA, 95207				[sources]
Last change	2024-12-12	Last processed	2026-02-15	First seen	2024-11-07

Sanctions
Country	Authority	Program	Start date	End date
United States	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

Source data IDs: us-medca-d32eb7fe60f567538546f3d12213e453d08e6ae9 · us-npi-1306939749

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