Healthcare Provider Details

I. General information

NPI: 1053451633
Provider Name (Legal Business Name): ROBERTSON RX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N ROBERTSON BLVD SUITE 107
BEVERLY HILLS CA
90211-1788
US

IV. Provider business mailing address

250 N ROBERTSON BLVD SUITE 107
BEVERLY HILLS CA
90211-1788
US

V. Phone/Fax

Practice location:
  • Phone: 310-278-2948
  • Fax:
Mailing address:
  • Phone: 310-278-2948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY GELFEN
Title or Position: PHARMACIST
Credential: PHARM D
Phone: 310-278-2948