Healthcare Provider Details

I. General information

NPI: 1518399831
Provider Name (Legal Business Name): KESHAV RX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 09/26/2024
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 W 6TH ST #107
CORONA CA
92882-1644
US

IV. Provider business mailing address

1307 W 6TH ST # 107
CORONA CA
92882-3294
US

V. Phone/Fax

Practice location:
  • Phone: 951-496-4408
  • Fax: 951-496-4412
Mailing address:
  • Phone: 951-496-4408
  • Fax: 951-496-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TAPAN PATEL
Title or Position: CEO/SEC./DIR
Credential:
Phone: 513-442-8078