Healthcare Provider Details
I. General information
NPI: 1467121251
Provider Name (Legal Business Name): CAPSULE SACRAMENTO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2021
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2821 J ST
SACRAMENTO CA
95816-4315
US
IV. Provider business mailing address
122 W 146TH ST
NEW YORK NY
10039-3802
US
V. Phone/Fax
- Phone: 916-546-3000
- Fax: 646-934-6409
- Phone: 888-685-9515
- Fax: 646-934-6409
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
KINARIWALA
Title or Position: SOLE MANAGER
Credential:
Phone: 888-685-9515