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General NPI Number Information
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NPI Number | 1215764303
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Entity Type | Organization
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Legal Business Name | SRX SACRAMENTO LLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 9837 FOLSOM BLVD STE K
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City | SACRAMENTO
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State | CA
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Zip | 95827-1356
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Country | US
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Telephone | 916-380-3153
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Fax |
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Provider Business Mailing Address
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Address Line | 9837 FOLSOM BLVD STE K
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City | SACRAMENTO
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State | CA
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Zip | 95827-1356
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Country | US
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Telephone | 916-380-3153
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SALOMON R ROMERO VALDEZ
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Credential |
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Telephone | 916-380-3153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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