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General NPI Number Information
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NPI Number | 1265422406
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Entity Type | Organization
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Legal Business Name | SIERRA RX INC
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2708 S FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90007-3255
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Country | US
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Telephone | 213-746-1828
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Fax | 213-746-4137
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Provider Business Mailing Address
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Address Line | 2708 S FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90007-3255
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Country | US
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Telephone | 213-746-1828
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Fax | 213-746-4137
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Authorized Official
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Title or Position | OWNER PHARMACIST IN CHARGE
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Name | DR. DON S GREENE
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Credential | PHARM D
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Telephone | 213-746-1828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHY32680
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License Number State | CA
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