Healthcare Provider Details

I. General information

NPI: 1164124400
Provider Name (Legal Business Name): ROSON PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9323 CHESAPEAKE DR STE C1
SAN DIEGO CA
92123-1034
US

IV. Provider business mailing address

9323 CHESAPEAKE DR STE C1
SAN DIEGO CA
92123-1034
US

V. Phone/Fax

Practice location:
  • Phone: 858-278-7500
  • Fax:
Mailing address:
  • Phone: 858-278-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JACOB PAUL RIXON
Title or Position: CEO/CFO/SECRETARY/DIRECTOR
Credential:
Phone: 760-898-2372