MEDICARE: RX CONSULTANTS GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336S0011X	Specialty Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PHY48772	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2000595	OTHER		PK

General Provider Information

NPI Number	:	1790854644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX CONSULTANTS GROUP INC

Provider Business Mailing Address
First Line	:	2621 S BRISTOL ST
Second Line	:	STE 100
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5766
Country	:	US
Telephone Number	:	714-754-1331
Fax Number	:	714-754-1314

Provider Business Practice Location Address
First Line	:	2621 S BRISTOL ST
Second Line	:	STE 100
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5766
Country	:	US
Telephone Number	:	714-754-1331
Fax Number	:	714-754-1314

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEAN LY
Credential	:	PHARM.D.
Telephone Number	:	714-754-1331

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	03/14/2022

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