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General NPI Number Information
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NPI Number | 1013233667
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Entity Type | Organization
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Legal Business Name | DELTA DRUGS II, INC.
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 2497 E LAKESHORE DR STE B
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-4437
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Country | US
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Telephone | 951-245-2325
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Fax | 951-245-4295
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Provider Business Mailing Address
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Address Line | 2497 E LAKESHORE DR UNIT B
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-4437
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Country | US
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Telephone | 951-245-2325
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Fax | 951-245-4295
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Authorized Official
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Title or Position | PRESIDENT
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Name | RITA AVAKIAN
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Credential |
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Telephone | 951-245-2325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50204
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License Number State | CA
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