Healthcare Provider Details

I. General information

NPI: 1124989181
Provider Name (Legal Business Name): ARISE PHARMACEUTICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10364 ARLINGTON AVE
RIVERSIDE CA
92505-1102
US

IV. Provider business mailing address

2857 CAMELLIA CT
CORONA CA
92882-3640
US

V. Phone/Fax

Practice location:
  • Phone: 217-240-2174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PETER WASIF
Title or Position: CEO
Credential:
Phone: 217-240-2174