Healthcare Provider Details

I. General information

NPI: 1548625296
Provider Name (Legal Business Name): RAFIQ LTD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 04/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6633 COYLE AVE STE 1
CARMICHAEL CA
95608-6346
US

IV. Provider business mailing address

6633 COYLE AVE STE 1
CARMICHAEL CA
95608-6346
US

V. Phone/Fax

Practice location:
  • Phone: 916-436-4731
  • Fax: 916-436-4958
Mailing address:
  • Phone: 916-436-4731
  • Fax: 916-436-4958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SAIRA RAFIQ
Title or Position: MANAGER / PIC
Credential:
Phone: 916-436-4731