Healthcare Provider Details

I. General information

NPI: 1700956885
Provider Name (Legal Business Name): DIVYA RX SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N EL CIELO RD D405
PALM SPRINGS CA
92262-6972
US

IV. Provider business mailing address

275 N EL CIELO RD D405
PALM SPRINGS CA
92262-6972
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-7999
  • Fax: 760-416-7688
Mailing address:
  • Phone: 760-416-7999
  • Fax: 760-416-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY55428
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHANDRA PATEL
Title or Position: PHARMACIST IN CHARGE
Credential: PHARM D.
Phone: 760-416-7999