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NPI Code Detail

MEDICARE: AMSAM ENTERPRISES LLC

MEDICARE: AMSAM ENTERPRISES LLC
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
13336C0003XCommunity/Retail PharmacyPHY55955CA

General Provider Information

NPI Number : 1912406158
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMSAM ENTERPRISES LLC
Provider Business Mailing Address
First Line : 7065 INDIANA AVE STE 310
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-4167
Country : US
Telephone Number : 951-370-1336
Fax Number : 951-370-1336
Provider Business Practice Location Address
First Line : 7065 INDIANA AVE STE 310
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-4167
Country : US
Telephone Number : 951-370-1336
Fax Number : 951-370-1336
Authorized Official
Title or Position : OWNER / PIC
Name : SAMEER RAKHOLIA
Credential :
Telephone Number : 951-370-1336
Provider Enumeration Date : 02/02/2018
Last Update Date : 02/06/2018

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Directions to “AMSAM ENTERPRISES LLC ” Practice Location

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