=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316940646
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIVER CITY PHARMACY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2005
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3301 C ST STE 450
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-454-0444
-----------------------------------------------------
Fax | 877-347-9053
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4222 PAYSPHERE CIR
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60674-0042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-452-3253
-----------------------------------------------------
Fax | 916-454-1406
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CFO
-----------------------------------------------------
Name | MEENAL SETHNA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 800-879-6137
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251F00000X
-----------------------------------------------------
Taxonomy Name | Home Infusion Agency
-----------------------------------------------------
License Number | PHY46743
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------